Recurrent second trimester pregnancy loss: evaluation and management

PURPOSE OF REVIEW: Recurrent pregnancy loss usually refers to first trimester losses. The present article describes the importance of a thorough evaluation for any patient presenting with a second trimester loss, and reviews current data regarding evidence-based evaluation and management for those families who have had recurrent episodes of second trimester losses. A management protocol is presented to guide management of a current pregnancy with a history of recurrent second trimester losses. RECENT FINDINGS: Previous literature has focused on isolated causes of second trimester loss and management. The present review incorporates all presentations of loss into a stepwise evaluative and management paradigm. SUMMARY: This comprehensive literature review and management protocol will provide the clinician with a thorough, systematic, and practical approach to the patient with recurrent pregnancy loss in order to maximize her chance of optimal pregnancy outcome.