New draft guideline outlines best practice for treating recurrent miscarriage

, an appointment at a miscarriage clinic for initial investigations after two miscarriages, and a full series of evidence-based investigations and care – as described in this guideline - after three miscarriages.

The guideline highlights the health disparities facing women from Black, Asian or minority ethnic backgrounds who are at a higher risk of having a miscarriage and calls for more research to be done to understand why this is the case.“A significant proportion of cases of recurrent miscarriage remain unexplained, despite detailed investigation. These women and their partners can be reassured that the prognosis for a successful future pregnancy with supportive care alone is in the region of 75%.

The guideline also incorporates the results from a major clinical trial published in 2019 - PRISM - which found that giving women with early pregnancy bleeding and a history of miscarriage self-administered twice daily progesterone pessaries can prevent some miscarriages. The guideline includes the results of a study in women with recurrent miscarriage that reported their preferred supportive care options for their next pregnancy, including a plan with one doctor who shows understanding, takes them seriously, has knowledge of their obstetric history, listens to them, gives information about recurrent miscarriage, shows empathy, informs on progress and enquires about emotional needs.

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