Recurrent Miscarriage QSD 2023 PDF

QUICK SUMMARY DOCUMENT Recurrent Miscarriage This Quick Summary Document (QSD) is a resource for all clinicians working in healthcare in Ireland who are in...

QUICK SUMMARY DOCUMENT Recurrent Miscarriage This Quick Summary Document (QSD) is a resource for all clinicians working in healthcare in Ireland who are involved in the care of women/couples with Recurrent Miscarriage. Following a comprehensive literature review a number of evidence-based recommendations for management of Recurrent Miscarriage were agreed upon. Key Recommendations STRUCTURE OF CARE 1. Investigation/evaluation of women/couples with RM can proceed after two consecutive pregnancy losses. 2. Couples should be referred to a RM clinic; this should have the appropriate staffing and clinical expertise, be appropriately located, with access to the required equipment and facilities. 3. Written information should be given in advance of appointments in the RM clinic, and further written information should accompany explanation of investigative findings, treatments and future pregnancy plans. COUNSELLING AND SUPPORTIVE CARE 4. Psychological counselling and support should be offered to couples with RM and tailored to their needs. INVESTIGATIONS 5. Medical, obstetric (for women) and family history should be used to tailor diagnostic investigations for women and men experiencing RM. 6. Maternal age and previous pregnancy history offer the best available prognostic information. 7. Advise women/couples regarding changes to potentially modifiable risk factors as relevant, including smoking cessation, maintaining a BMI between 19-25, healthy eating and physical activity (normal exercise pattern; not excessive), abstaining from alcohol and drug consumption (including caffeine, which should be reduced to