Recurrent miscarriage and thrombophilia:  an update.
OBJECTIVE
Acquired and inherited thrombophilia is an important research avenue in the recurrent miscarriage field. The optimum treatment for patients with recurrent miscarriage and a confirmed thrombophilia remains a contentious issue. We aim to appraise and explore the latest research in the field of thrombophilia and recurrent miscarriage in this review.


RESULTS
Antiphospholipid syndrome (APS) is the only proven thrombophilia that is associated with adverse pregnancy outcomes. Research involving inherited thrombophilia and recurrent miscarriage is limited to small observational studies with small and heterogeneous populations. Aspirin and heparin therapy are frequently prescribed for APS, yet there is no robust evidence for the most efficacious regime. The combination of inherited hypercoagulability and environmental factors in association with recurrent miscarriage has recently been explored as an aid to identify high-risk individuals.


CONCLUSIONS
The cause of recurrent miscarriage is multifactorial and appropriate treatment continues to be a challenge. Laboratory tests need to be standardized and well designed multicentre research trials are essential to expand on the current knowledge base with the aim to produce strong evidence-based medicine.
Liverpool Women's NHS Foundation Trust, Liverpool, UK. kellymcnamee@doctors.org.uk
Kelly
K
McNamee
Feroza
F
Dawood
Roy
R
Farquharson
D000026:Abortion, Habitual / Q000209:etiology* / Q000517:prevention & control / Q000523:psychology; D000925:Anticoagulants / Q000627:therapeutic use*; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000188:drug therapy / Q000523:psychology; D001241:Aspirin / Q000627:therapeutic use; D019317:Evidence-Based Medicine; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy / Q000209:etiology* / Q000523:psychology; D018566:Pregnancy, High-Risk; D019851:Thrombophilia / Q000150:complications* / Q000188:drug therapy / Q000523:psychology
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D001241:Aspirin