Miscarriage Top 10

Please click on each question for more detailed information:

  1. What are the effective interventions to prevent miscarriage, threatened miscarriage and recurrent miscarriage? (eg, lifestyle, vitamins, aspirin, early scans, human chorionic gonadotrophin(HCG), dopamine agonists, progestogen, polytherapy, steroids, oestrogen, metformin, anticoagulants, intravenous immunoglobulin, intralipid and anti-TNF-alpha)
  2. What are the emotional and mental health impacts of miscarriage in the short term and long term for the mother and the partner?
  3. What investigations are of true clinical value? (eg, ultrasound, gene sequencing, natural killer cells, thromboelastography, microarray testing of the fetus, paternal investigations, plasminogen activator inhibitor polymorphism)
  4. To what extent do pre-existing medical conditions cause miscarriage? (eg, vitamin deficiencies, diabetes, previous infertility, endometriosis, polycystic ovarian syndrome, menstrual irregularities, cervical factors, uterine anomalies, polyps, immunological factors or previous pregnancy complications for example, caesarean section or preterm birth)
  5. What types of emotional support are effective in preventing or treating women or their partners after a miscarriage?
  6. Do lifestyle factors (diet, stress, exercise, weight, alcohol, sexual activity, smoking, night shifts or flying) cause miscarriage?
  7. To what extent do genetic and chromosomal abnormalities in the fetus cause miscarriage?
  8. What preconception tests or interventions prevent miscarriage? (eg, vitamin supplements, folic acid, dehydroepiandrosterone, co-enzyme Q-10 or bariatric surgery)
  9. What are the appropriate investigations for women after one, two, or three or more miscarriages?
  10. What male factors contribute towards the cause of miscarriage?

The following questions were also discussed and put in order of priority at the workshop:

  1. Can miscarriage of a current pregnancy be predicted? (e.g. by  ultrasound, blood test or vaginal tests)
  2. Why does society not talk about miscarriage?
  3. Does the method of management of miscarriage affect future fertility or miscarriage?
  4. What type of care reduces anxiety during a subsequent pregnancy after miscarriage?
  5. What causes recurrent (more than three to the same woman) miscarriages?
  6. What causes miscarriage?
  7. Could women be better prepared for the possibility of miscarriage?
  8. What is the probability of a further miscarriage after one, two or three or more  previous miscarriage(s)?
  9. What is the best societal support for women with miscarriage (leave from work e.g. same as stillbirth)?
  10. What is the best time to conceive after a miscarriage?
  11. To what extent do parental factors cause miscarriage? (e.g. genetic, chromosomal, blood group)
  12. What types of care are effective in preventing mental health problems for mothers and their partners during and immediately after a miscarriage?
  13. What are the risks after a miscarriage? (such as change in menstrual pattern or mental health problems)
  14. What causes missed miscarriage, where the baby dies before the miscarriage occurs?
  15. Does fetal gender cause miscarriage in some women?

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For full details of all of the questions identified by this PSP, please see the document below.