title: [Early recurrent miscarriage: Evaluation and management].
abstract: OBJECTIVE
  To establish recommendations for early recurrent miscarriages (≥3 miscarriages before 14weeks of amenorrhea).
  
  
  METHODS
  Literature review, establishing levels of evidence and recommendations for grades of clinical practice.
  
  
  RESULTS
  Women evaluation includes the search for a diabetes (grade A), an antiphospholipid syndrome (APS) (grade A), a thyroid dysfunction (grade A), a hyperprolactinemia (grade B), a vitamin deficiency and a hyperhomocysteinemia (grade C), a uterine abnormality (grade C), an altered ovarian reserve (grade C), and a couple chromosome analysis (grade A). For unexplained early recurrent miscarriages, treatment includes folic acid and progesterone supplementation, and a reinsurance policy in the first quarter (grade C). It is recommended to prescribe the combination of aspirin and low-molecular-weight heparin when APS (grade A), glycemic control in diabetes (grade A), L-Thyroxine in case of hypothyroidism (grade A) or the presence of thyroid antibodies (grade B), bromocriptine if hyperprolactinemia (grade B), a substitution for vitamin deficiency or hyperhomocysteinemia (grade C), sectionning a uterine septum (grade C) and treating an uterine acquired abnormality (grade C).
  
  
  CONCLUSIONS
  These recommendations should improve the management of couples faced with early recurrent miscarriages.
authors.affiliation: Service de gynécologie-obstétrique, hôpital Antoine-Béclère, AP-HP, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France. Electronic address: vanessa.gallot@abc.aphp.fr.
authors.forename: V
authors.initials: V
authors.lastname: Gallot
authors.affiliation: Service de gynécologie-obstétrique, hôpital Antoine-Béclère, AP-HP, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France.
authors.forename: S
authors.initials: S
authors.lastname: Nedellec
authors.affiliation: Service de gynécologie-obstétrique, hôpital Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94276 Le Kremlin-Bicêtre, France.
authors.forename: P
authors.initials: P
authors.lastname: Capmas
authors.affiliation: Service de gynécologie-obstétrique, CHU d'Angers, 4, rue Larrey, 49033 Angers cedex 01, France.
authors.forename: G
authors.initials: G
authors.lastname: Legendre
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalier d'Auch-en-Gascogne, allée Marie-Clarac, 32008 Auch, France.
authors.forename: V
authors.initials: V
authors.lastname: Lejeune-Saada
authors.affiliation: Service de gynécologie-obstétrique, CHU Jeanne-de-Flandre, 59037 Lille cedex, France.
authors.forename: D
authors.initials: D
authors.lastname: Subtil
authors.affiliation: Service de gynécologie-obstétrique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Inserm U1150, CNRS UMR 7222, UPMC université Paris 06, Sorbonne universités, 75005 Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Nizard
authors.affiliation: Service de gynécologie-obstétrique, CHU Anne-de-Bretagne, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France.
authors.forename: J
authors.initials: J
authors.lastname: Levêque
authors.affiliation: Service de gynécologie-obstétrique, hôpital Antoine-Béclère, AP-HP, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France.
authors.forename: X
authors.initials: X
authors.lastname: Deffieux
authors.affiliation: Unité de cytogénétique, CHI Poissy-St-Germain, 10, rue du Champ-Gaillard, 78300 Poissy, France; EA 2493, UFR des sciences de la santé, 2, avenue de la Source-de-le-Bièvre, 78180 Montigny-Le-Bretonneux, France.
authors.forename: B
authors.initials: B
authors.lastname: Hervé
authors.affiliation: Unité de cytogénétique, CHI Poissy-St-Germain, 10, rue du Champ-Gaillard, 78300 Poissy, France; EA 2493, UFR des sciences de la santé, 2, avenue de la Source-de-le-Bièvre, 78180 Montigny-Le-Bretonneux, France.
authors.forename: F
authors.initials: F
authors.lastname: Vialard
mesh_terms: D000026:Abortion, Habitual / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D005260:Female; D006801:Humans; D017410:Practice Guidelines as Topic / Q000592:standards*; D011247:Pregnancy
keywords: Caryotype; Chronic endometritis; Endocrinopathies; Environment; Environnement; Fausses couches à répétition; Malformation utérine; Pathologie auto-immune; Pathologies maternelles; Poids; Polymorphisme; Recurrent miscarriage; Recurrent pregnancy loss; Réserve ovarienne; SAPL; Spontaneous abortion; Toxique; Vitamines; Vitamins; Weight; Âge