Current Approach on Recurrent Pregnancy Loss; Clinical and immunological Case-Control Study.

Abstract

Background: Recurrent pregnancy loss (RPL) is the most common and challenging condition in the field of reproductive medicine. Only around 50% of RPL cases have defined causes or risk factors, and still there are few diagnostic and treatment strategies available. Therefore, it's essential to establish other evidence-based diagnostic checkpoints aiming at enhancing management and improving pregnancy outcome in such cases.

Methods: A case-control study included 60 pregnant women from the antenatal care clinic at Zagazig University Hospitals during the period April 2020 through April 2024. The study cases were divided into four equal groups: Group 1 normal cases, Group 2 RPL cases, Group 3 RPL cases under treatment, and Group 4 non-recurrent cases. All cases were subjected to thorough history, clinical examination and laboratory investigations that included important immune markers as anti-phospholipid and anti-thyroid antibodies beside routine lab. work. The collected data was analyzed using the appropriate statistical methods.

Results: Educated, rural, and nonsmoking women made up most of the recruited cases. Their age ranges between 20 and 38 years. All cases were matched in terms of demographics, clinical and medical conditions, as well as risk factors for RPL, with no statistically significant differences. In this case-control study, the most common clinical entity with an immunologic basis was anti phospholipid syndrome (5 cases, 33%, in the RPL group  and 3 cases ,20.0%, in the RPL group that were under treatment) .This was significantly higher (P = 0.04) than in the control group and Group 4 (0.0%). Conclusion: after the exclusion of all risk factors for RPL, 50% of cases have no causes.  APS was the most common cause (33.3%) of RPL .