Objective: To establish recommendations for early recurrent miscarriages (≥3 miscarriages before 14weeks of amenorrhea).
Materials and 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).
Conclusion: These recommendations should improve the management of couples faced with early recurrent miscarriages.
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.
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