An observational study of causes of recurrent pregnancy loss in rural Population

Introduction: Our aim was to identify causes of recurrent pregnancy loss in rural population in Maharashtra in Indian population Method: A longitudinal observation study was carried out in the Obst and Gynae department , Pravara Hospital . The study enrolled 70 patients aged 18 to 44 years with history of at least two or more miscarriages less than 20 weeks gestation. They were divided into 3 groups -Group A patients with history of two or more pregnancy losses who reported to OPD immediately after abortion of their last pregnancy; Group B - patients with history of recurrent pregnancy loss but < 20 weeks of gestation in their present pregnancy at the time of inclusion in study; Group C - patients with history of recurrent pregnancy loss but more than 20weeks gestation in their present pregnancy at the time of inclusion in the study. A detailed clinical history , thorough clinical examination and investigated with a certain group of pre-decided laboratory tests and special tests wherever relevant and possible, were done. The causes of RPL were evaluated. Results: Underlying causes were diagnosed in 35% cases ,while 65% cases remained unexplained. Anatomical causes were detected in 20% cases , wherein incompetent cervix was the most common cause while uterine malformations were present in 23.5% cases among which septate uterus was most common . 6% had Endocrine etiology ,comprising of hypothyroidism and diabetes mellitus . Infective cause in 6% and autoimmune causes in 3% patients. Conclusion: From our study we conclude that , even after detailed evaluation majority of cases of RPL remain unexplained . Anatomical causes account for majority causes in RPL .