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Recurrent Pregnancy Loss (RPL) Clinic


Our Recurrent Pregnancy Loss (RPL) Clinic is run by nurses every Tuesday and Thursday. We have doctors assigned to see new patients who are not pregnant and to scan pregnant patients weekly for support and monitoring.

In this clinic, we use an evidence-based approach to treatment. We run tests and try to establish as quickly as possible if there is any underlying reason for a couple experiencing RPL.

 

Who should be referred?

Women can be seen in the RPL clinic if they are:

  • under 40 years of age;
  • have had three or more consecutive first trimester pregnancy losses >6 weeks confirmed by scan/blood test/history. Excluding molar, partial molar and ectopic pregnancies.
  • living within the wider Auckland area.

 

Pre-referral investigations

Your GP will need to arrange a number of investigations before you come to the RPL clinic that will allow us to provide answers for you more quickly. These include:

  • Maternal and Paternal peripheral blood karyotyping
  • Maternal Antenatal Screen including Hep B, C and HIV
  • Lupus Anticoagulant
  • Anticardiolipin Antibodies (if above 20, please repeat in twelve weeks time)
  • APC resistance
  • Thyroid Stimulating Hormone
  • Day 2 or 3 menses FSH (with Estradiol level)
  • HbA1c
  • B2 glycoprotein 1
  • 3D Transvaginal ultrasound of pelvis – if not completed, we will arrange for this publicly at Greenlane Radiology Department if all investigations are completed.

 

Our approach to treatment

If you are referred to us, you will have a clinic review and appropriate investigation. We can then tailor our management for you, depending on the cause of your pregnancy losses.

In just over half the couples we see, no specific cause is found. This is what we call 'unexplained' RPL. We offer these couples advice on lifestyle factors and early pregnancy support and monitoring through the first trimester of the next pregnancy.

The chance of a successful pregnancy with these measures is around 70%. Where an underlying cause for their RPL is found, couples will be offered specific treatment to help improve their chances of a live birth in the future.