Risk factors of recurrent spontaneous abortion [I fattori di rischio di aborto spontaneo ricorrente]

Recurrent spontaneous abortion (RSA) is defined as three or more consecutive miscarriages occurring before the twentieth week of gestation. RSA is associated with a series of etiological factors of genetic, anatomical, hormonal, immunological and infective nature. Many RSA cases the etiology remains unknown. In this paper we are going to assess the incidence of these risk factors occurring in RSA cases that have come to our observation. A retrospective study has been conducted examining the medical records of 30 patients with at least two or more recurrent spontaneous miscarriages occurring before the fifteenth week of gestation and coming to the outpatient clinic of Gynecological Endocrinology (Gynecological and Obstetrical Department at "Vittorio Emanuele Hospital") and Pathophysiology of Human Reproduction ("S. Bambino" Hospital) in the last five years. We find that: alterations of coagulation factors are present in 18 couples out of 30 (60%); autoimmune factors (many different auto-antibodies) are present in 10 couples out of 30 (33,3%); luteal phase deficiency is present in 5 couples out of 30 (16,7%); karyotype anomalies are present in 3 couples out of 30 (10%); anatomical anomalies are present in 2 couples out of 30 (6,7%); These risk factors surface both one at a time and in association among each other. It is essential to identify the causes and etiological factors that underpin RSA, in order to implement the best treatment plan, if that is possible. However, the outcome of pregnancy is complicated in a statistically significant way by an association of multiple risk factors.