The etiology of early pregnancy loss is varied and often controversial. More than 1 etiologic factor is often present. The most common causes of recurrent miscarriages are as follows:
- Genetic causes
- Mendelian disorders
- Genetic translocations
- Multifactorial disorders
- Chromosomal inversions
- Sex-chromosome aneuploidies
- Autoimmune causes
- Immunologic causes
- Alloimmune causes
- Anatomic causes
- Uterine müllerian anomaly
- Uterine septum (the anomaly most common associated with pregnancy loss)
- Hemiuterus (unicornuate uterus)
- Bicornuate uterus
- Diethylstilbestrol-linked condition
- Acquired defects (eg, Asherman syndrome)
- Incompetent cervix
- Leiomyomas
- Uterine polyps
- Uterine müllerian anomaly
- Infectious causes
- Environmental causes
- Smoking
- Excessive alcohol consumption
- Endocrine factors
- Diabetes mellitus
- Antithyroid antibodies
- Luteal-phase deficiency
- Hematologic disorders
The gestational age at the time of the SAB can provide clues about the cause. For instance, nearly 70% of SABs in the first 12 weeks are due to chromosomal anomalies. However, losses due to antiphospholipid syndrome (APS) and cervical incompetence tend to occur after the first trimester.
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