Consultation with a maternal-fetal specialist should be
considered in women with a history of recurrent spontaneous
abortion and mid-trimester abortion/delivery.Recurrent abortion and very preterm birth may be
related to uterine structural defects such as Müllerian
tube defects (uterine septum and variants), uterine
leiomyomata, or cervical incompetence. A specific history
of preterm premature rupture of membranes may
be caused by infection, a modifiable factor, whereas a
history of premature labor may be attributable to a
number of factors.
Patients with recurrent first trimester loss should
be offered genetic evaluation. Genetic consultation is
applicable for a growing list of preconception concerns,
including couples with a previous child with a
congenital defect, families with inherited metabolic
defects, and couples wherein one partner manifests a
genetically transmitted illness.
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