Spontaneous abortion is defined as the spontaneous loss of pregnancy prior to the 20th gestational week of pregnancy. Pregnancy losses which occur during this period of time are said to occur in about 15 percent of pregnancies. At the same time, the risk of miscarriage increases proportionately to the number of previous miscarriages experienced. Unfortunately, a definite cause has been difficult to determine. Over the years, miscarriages have been observed as a somewhat “normal” finding. Often it has been thought to be “nature’s way” of ending a pregnancy which was doomed to fail in any regard. However, there has developed a somewhat more aggressive approach over the last 5 to 10 years towards evaluation and management of women with spontaneous abortion. It is now well recognized that a definition of recurrent pregnancy loss includes two or more consecutive spontaneous miscarriages and that this warrants a full evaluation. Furthermore, it is becoming more and more recognized that there appears to be an association between infertility and spontaneous abortion.
** A variety of factors underlie the occurrence of miscarriage. These include genetic, endocrinologic (hormonal), anatomic, immunologic and microbiologic variations. We are slowly coming to recognize that no miscarriage can be considered normal.** All miscarriages are the result of a pathophysiologic reproductive event. It is the current challenge of medicine to find those underlying causes and, in some cases, underlying causes that are common occurrences are often overlooked.