Early pregnancyFree in the app
Recurrent miscarriage
Three or more first-trimester losses (investigate after 2 if a cause is suspected).
Source: RCOG GTG 17 (2023)Investigate
- Lupus anticoagulant and anticardiolipin antibodies
- Thyroid function and TPO antibodies
- 3D ultrasound for uterine anomaly
- Pregnancy tissue karyotype (3rd+ loss); parental karyotype if unbalanced or no tissue
- Thrombophilia (FVL, prothrombin, protein S) only after second-trimester loss
Treat
- Antiphospholipid syndrome: aspirin + heparin from positive test to ≥34 weeks
- Bleeding in early pregnancy: vaginal progesterone 400 mg BD to 16 weeks
- No aspirin/heparin for unexplained loss; no levothyroxine if TPO+ with normal thyroid
- Lifestyle: BMI 19–25, caffeine <200 mg/day
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.