Imperial College London
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ProfessorPhillipBennett

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Clinical Professor
 
 
 
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Contact

 

+44 (0)20 7594 2176p.bennett

 
 
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Assistant

 

Miss Kiran Dosanjh +44 (0)20 7594 2176

 
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Location

 

Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Coomarasamy:2021:10.1016/S0140-6736(21)00681-4,
author = {Coomarasamy, A and Dhillon-Smith, RK and Papadopoulou, A and Al-Memar, M and Brewin, J and Abrahams, VM and Maheshwari, A and Christiansen, OB and Stephenson, MD and Goddijn, M and Oladapo, OT and Wijeyaratne, CN and Bick, D and Shehata, H and Small, R and Bennett, PR and Regan, L and Rai, R and Bourne, T and Kaur, R and Pickering, O and Brosens, JJ and Devall, AJ and Gallos, ID and Quenby, S},
doi = {10.1016/S0140-6736(21)00681-4},
journal = {The Lancet},
pages = {1675--1682},
title = {Recurrent miscarriage: evidence to accelerate action},
url = {http://dx.doi.org/10.1016/S0140-6736(21)00681-4},
volume = {397},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Women who have had repeated miscarriages often have uncertainties about the cause, the likelihood of recurrence, the investigations they need, and the treatments that might help. Health-care policy makers and providers have uncertainties about the optimal ways to organise and provide care. For this Series paper, we have developed recommendations for practice from literature reviews, appraisal of guidelines, and a UK-wide consensus conference that was held in December, 2019. Caregivers should individualise care according to the clinical needs and preferences of women and their partners. We define a minimum set of investigations and treatments to be offered to couples who have had recurrent miscarriages, and urge health-care policy makers and providers to make them universally available. The essential investigations include measurements of lupus anticoagulant, anticardiolipin antibodies, thyroid function, and a transvaginal pelvic ultrasound scan. The key treatments to consider are first trimester progesterone administration, levothyroxine in women with subclinical hypothyroidism, and the combination of aspirin and heparin in women with antiphospholipid antibodies. Appropriate screening and care for mental health issues and future obstetric risks, particularly preterm birth, fetal growth restriction, and stillbirth, will need to be incorporated into the care pathway for couples with a history of recurrent miscarriage. We suggest health-care services structure care using a graded model in which women are offered online health-care advice and support, care in a nurse or midwifery-led clinic, and care in a medical consultant-led clinic, according to clinical needs.
AU  - Coomarasamy,A
AU  - Dhillon-Smith,RK
AU  - Papadopoulou,A
AU  - Al-Memar,M
AU  - Brewin,J
AU  - Abrahams,VM
AU  - Maheshwari,A
AU  - Christiansen,OB
AU  - Stephenson,MD
AU  - Goddijn,M
AU  - Oladapo,OT
AU  - Wijeyaratne,CN
AU  - Bick,D
AU  - Shehata,H
AU  - Small,R
AU  - Bennett,PR
AU  - Regan,L
AU  - Rai,R
AU  - Bourne,T
AU  - Kaur,R
AU  - Pickering,O
AU  - Brosens,JJ
AU  - Devall,AJ
AU  - Gallos,ID
AU  - Quenby,S
DO  - 10.1016/S0140-6736(21)00681-4
EP  - 1682
PY  - 2021///
SN  - 0140-6736
SP  - 1675
TI  - Recurrent miscarriage: evidence to accelerate action
T2  - The Lancet
UR  - http://dx.doi.org/10.1016/S0140-6736(21)00681-4
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000645510600028&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://www.sciencedirect.com/science/article/pii/S0140673621006814?via%3Dihub
UR  - http://hdl.handle.net/10044/1/92246
VL  - 397
ER  -
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