Published: 19 June 2023
The guideline provides comprehensive information on risk factors, recommended investigations and treatments for recurrent first trimester and one or more second trimester miscarriages.
It also discusses provisions for the management of any subsequent miscarriages, in terms of women and people receiving appropriate supportive care via informed and empathetic communication with healthcare professionals, ultrasound examinations and prompt access to services.
This guideline defines recurrent miscarriage as three or more first trimester miscarriages, in keeping with previous versions. However, clinicians are encouraged to use their clinical discretion to recommend extensive evaluation after two first trimester miscarriages, if there is a suspicion that the miscarriages are of pathological and not of sporadic nature. Furthermore, as the incidence of certain diagnoses does not appear to differ between women with consecutive versus non-consecutive losses, the definition in this guideline has not been restricted to women and people suffering with consecutive miscarriages only nor miscarriages suffered with the same partner, as certain maternal pathologies would be unaffected by the partner.
To conclude, areas of uncertainty are highlighted along with recommendations for future research in this field.
Version history
The first edition of this guideline was published in 1998 (as The Investigation and Treatment of Couples with Recurrent Miscarriage); the second edition was published in 2003; and the third edition was published in 2011 (as The Investigation and Treatment of Couples with Recurrent First trimester and Second trimester Miscarriage). This is the fourth edition of this guideline, published in 2023. Next review date: 2026.
Developers’ declarations of interest
Available on request.