title: First trimester miscarriage evaluation.
abstract: Miscarriage is a relatively common occurrence for otherwise healthy women. Despite its frequency, evaluation for cause is rare. The most common cause of miscarriage is sporadic chromosome errors. Chromosomal analysis of the miscarriage offers an explanation in at least 50% of cases. Conventional cytogenetic evaluation can only be done on fresh tissue, so it is critical that the treating physician consider genetic testing at the time of the miscarriage. Ultrasound can estimate the gestational age at the time of miscarriage and identify major abnormalities in some embryos. A careful pathological examination can add to the evaluation by ruling out rare disorders with the highest recurrence risk. A multidisciplinary approach to miscarriage evaluation is essential to understanding the cause and risk of recurrence. A thorough evaluation of a miscarriage, in combination with emotional support, can often provide the necessary reassurance and confidence as the patient prepares for her next pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, Recurrent Pregnancy Loss Program, Stanford University, Stanford, California 94305, USA. rlathi@stanford.edu
authors.forename: Ruth B
authors.initials: RB
authors.lastname: Lathi
authors.forename: Florette K
authors.initials: FK
authors.lastname: Gray Hazard
authors.forename: Amy
authors.initials: A
authors.lastname: Heerema-McKenney
authors.forename: Joanne
authors.initials: J
authors.lastname: Taylor
authors.forename: Jane Tsung
authors.initials: JT
authors.lastname: Chueh
mesh_terms: D037881:Aborted Fetus / Q000098:blood supply / Q000378:metabolism / Q000473:pathology*; D000022:Abortion, Spontaneous / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000235:genetics; D002824:Chorionic Villi / Q000473:pathology; D002869:Chromosome Aberrations / Q000196:embryology; D002885:Chromosomes, Human, Pair 16; D041321:Chromosomes, Human, X; D003656:Decidua / Q000473:pathology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology; D009006:Monosomy; D009030:Mosaicism / Q000196:embryology; D010920:Placenta / Q000473:pathology*; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000235:genetics / Q000378:metabolism; D014314:Trisomy; D014463:Ultrasonography