Chapter 26 - Late pregnancy loss

Summary

Women who suffer late pregnancy loss represent a heterogeneous group, displaying widely varying presentation and etiology. Antiphospholipid antibody syndrome is associated with pregnancy loss in any trimester. Early fetal loss commonly occurs in the first trimester while others found that their patients with antiphospholipid antibody syndrome (APS) mostly lost pregnancies in the second or early third trimester. Clinical experience with transabdominal cerclage for recurring late pregnancy loss is limited in the UK to a few centers. Selection criteria vary between centers and often include patients with pre-term delivery histories and bad outcome as well as classical mid-trimester loss due to true cervical weakness. A recent systematic review stated that transabdominal cervical cerclage may be associated with a lower risk of perinatal death or delivery at less than 24 weeks gestation, but it may also be associated with a higher risk of operative complications.