Information for Patients
Recurrent Miscarriage Clinic
You have been referred to this Recurrent Miscarriage Clinic to identify if there is an underlying
cause for your miscarriages.
How common is miscarriage?
Approximately 1 in 6 pregnancies ends in miscarriage, it is a more common problem than
most people imagine and can be a unhappy, lonely and distressing experience. 1 in 100
couples trying for a baby experiences recurrent miscarriages usually defined as 3 or more
miscarriages in a row.
Why investigate only after 3 miscarriages?
Investigations aren’t usually offered to woman after 1 or 2 miscarriages, this is due to
statistics showing their chances of a successful pregnancy next time are extremely good,
suggesting their miscarriage were due to chance rather than an underlying cause.
If a woman has 3 or more in a row statistics show it is more likely to be an underlying cause,
so referral to the recurrent miscarriage clinic is advised for investigations.
What investigations will be done?
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chromosomal analysis
immunological tests
hormonal tests
infection tests
sticky blood tests
Pre-conceptual Care
Research
Chromosomal Analysis
Chromosomes carry genetic information, everyone has 23 pairs of chromosomes making 46
in all. When you conceive the baby receives half its chromosomes from the mother and half
from its father.
In 3-5% of couples one partner may have a chromosomal rearrangement called a balanced
translocation. This means that they have the right number of chromosomes but they are
arranged differently, although this doesn’t cause a problem to the affected parent it can be
passed on to the baby, this can lead to a miscarriage.
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Information for Patients
Immunological tests and Antiphospholipid syndrome
Throughout pregnancy blood flow between the mother and baby is very important, there are a
large group of antibodies that may affect the blood supply in the placenta or cause abnormal
implantation of the placenta in the wall of the uterus. 15% of women who experience recurrent
miscarriage have high levels of these antibodies.
Some people have blood that clots too easily because of abnormalities inherited from their
parents. We will test to see if you have these. If you do we will refer you to experts in these
abnormalities who will give advice on treatments to thin your blood.
Hormonal tests
A high thyroid imbalance in a woman not diagnosed or poorly controlled could cause her to
have a miscarriage, the same with a woman not diagnosed or poorly controlled with diabetes.
If properly controlled both medical conditions would not cause a miscarriage therefore you will
be offered these 2 tests.
Infection tests
In general infection is not thought to be a cause of recurrent miscarriage however severe
infection at the time of miscarriage could be the cause. Treatment is very simple and easy in
the form of antibiotics.
Pre-conceptual care
When you are ready to try for another pregnancy it is better that your body is ready, therefore
in the clinic we feel it is important that we check this, we will check your vitamin D, calcium,
sugar and iron levels so that if you are found deficient in these areas they can be treated
before you get pregnant.
Research in the clinic
We believe in the clinic that all causes of miscarriage are not yet known therefore we strive to
find causes in a safe way via research. If this is something you are interested in please ask.
Other causes of miscarriage
There are a number of less common causes of miscarriage, they are cervical weakness and
uterine abnormalities (associated with later miscarriages), if appropriate these will be
discussed with you and further tests would be arranged.
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Information for Patients
What happens next?
A follow up appointment is made for you and your partner to return to the clinic where your
results will be available and together with your history Professor Quenby, Consultant, will
make a plan for your next pregnancy.
Support in subsequent pregnancy
After a pregnancy loss the anxiety experienced in the following pregnancy can be quite high.
Staff in the clinic will offer you support by giving you ultrasound scans from appropriate
gestations. Once you have a positive pregnancy test you can telephone the number below
and leave a message for the staff who will then arrange your ultrasound scan and implement
your plan of care that the consultant discussed with you.
Clinic team
Professor Siobhan Quenby
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Consultant
Rachel Small
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Miscarriage Midwife Specialist
Telephone number
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0121 424 3505
Useful contacts
Miscarriage Association: 01924 200799
www.miscarriageassociation.org.uk
The Association of Early Pregnancy Units: www.assocationofearlypregnancyunits.org.uk
Next Appointments:
Date
Time
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Where
With
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Information for Patients
Additional Sources of Information:
You can go online and view NHS Choices website for more information about a wide range of
health topics http://www.nhs.uk/Pages/HomePage.aspx
You may want to visit one of our Health Information Centres located in:
 Main Entrance at Birmingham Heartlands Hospital Tel: 0121 424 2280
 Treatment Centre at Good Hope Hospital Tel: 0121 424 9946
or contact us by email: healthinfo.centre@heartofengland.nhs.uk.
Our commitment to confidentiality
We keep personal and clinical information about you to ensure you receive appropriate care
and treatment. Everyone working in the NHS has a legal duty to keep information about you
confidential.
We will always ask you for your consent if we need to use information that identifies you. We
will share information with other parts of the NHS to support your healthcare needs, and we
will inform your GP of your progress unless you ask us not to. You can help us by pointing
out any information in your records which is wrong or needs updating.
Dear Patient
We welcome your views on what you liked and suggestions for how things could be improved
at this hospital. If you would like to tell us and others about your experience please make your
comments through one of the following sites:


NHS Choice:Patient Opinion:I want great care:doctor)
www.nhs.uk
www.patientopinion.org.uk
www.iwantgreatcare.org (Here you can leave feedback about your
Be helpful and respectful: think about what people might want to know about this hospital or
how your experiences might benefit others. Remember your words must be polite and
respectful, and you cannot name individuals on the NHS Choice or Patient Opinion sites.
If you have any questions you may want to ask about your condition or treatment, or
anything you do not understand or wish to know more about, write them down and
your doctor will be more than happy to try and answer them for you.
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