Pregnancy Loss Prevention Center: Clinical Experience

Worldwide there is a growing interest in recurrent pregnancy loss and stillbirth, however, each is viewed as a separate problem. We suggest that they overlap and share many of the same causes. There are differences in the developing nations compared with the developed nations in the incidence of stillbirths and specific causes. Globally there are very few centers for addressing these problems, and usually only for recurrent pregnancy loss.

In the U.S. there are no centers for Pregnancy Loss which combine REI, MFM, Genetics, Medicine and Psychiatry except for the Pregnancy Loss Prevention Center at NYU-Langone Medical Center. The goal is a multi-disciplinary center for all patients at risk of pregnancy loss, including RPL and patients with a diagnosis placing them at increased risk for pregnancy loss.

The current structure is a center within the Department of Obstetrics and Gynecology. There is a website and phone number as a central contact for the services. All subspecialties and a core of REI, MFM, Genetics, Medicine and Psychiatric physicians with various subspecialties, ultrasound and laboratory support are available. Comprehensive diagnostic evaluations with a full report to the referring source with specific recommendations for treatment are provided. When needed the suggested therapy or referral for treatments are offered. Bereavement counseling and support are also available. The first 100 patients experience is reviewed. Inclusion criteria were ≥ 2 pregnancy losses. The most common diagnoses were: intrauterine synechiae, fibroids, luteal phase defect, cervical incompetence, abnormal genetics and hypothyroidism. Consultation resulted in 63 full term births, 4 spontaneous abortions, 15 patients who did not conceive, 17 ongoing pregnancies and 4 patients lost to follow-up.