Recurrent miscarriage in Malta: an analysis of 135 patients referred to the miscarriage clinic

Abstract

Recurrent miscarriage affects about 1 % oc couples who are trying to have children. The classical definition of recurrent miscarriage i.e three consecutive losses is an epidemiological one based on risk estimates of a miscarriage following each consecutive loss. This definition does not, however, take into consideration those couples who have already faced two recurrent miscarriages and are desperate to have a child. When the miscarriage clinic was set-up it was recognized that the management of this condition was subject to the individual interpretation of gynaecologists caring for these patients. The concept was that all patients should receive the best possible care and with this in mind it was decided that two recurrent miscarriages would qualify for referral and management. Another concept which the clinic adopted is a comprehensive investigation protocol as opposed to a highly selective one. This ensured that all possible pathologies which may be associated with miscarriage would be identified. The results will show that a number of women were found to have medical problems through this approach.

A particluar attention to modern treatment protocols ensured that patients were prescribed the most effective treatment possible for their condition. The availability of a miscarriage clinic is in itself the most important factor for the largest group i.e. the idiopathic group and guarantees an improvement in outcome which was clearly shown in the results. In conclusion, the setting-up of a miscarriage clinic improved the care for these patients and contributed to the overall success reported for these unfortunate patients.