Journal Health of Woman. 2026. 1(182): 91-105. doi: 10.15574/HW.2026.1(182).91105
Duka Yu. M., Panov V. V., Plyg O. O.
Dnipro State Medical University, Ukraine

For citation: Duka YuM, Panov VV, Plyg OO. (2026). Key «red flags» in the aetiology of recurrent pregnancy loss: latest recommendations and an analysis of emerging «conflicts» (a literature review). Ukrainian Journal Health of Woman. 1(182): 91-105. doi: 10.15574/HW.2026.1(182).91105
Article received: Nov 16, 2025. Accepted for publication: Jan 28, 2026.

Recurrent pregnancy loss (RPL) remains one of the most complex and controversial issues in modern reproductive medicine, due to the multifactorial nature of its pathogenesis and the significant proportion of idiopathic cases. Differences and discrepancies in the definitions of recurrent miscarriage lead to difficulties in assessing its true prevalence. The incidence of recurrent miscarriage may be underestimated, as few countries require pregnancy loss to be recorded as a separate indicator in national health databases. All these factors contribute to an underestimation of the prevalence of recurrent miscarriage in some regions of the world.
Aim – to analyse the evolving understanding of the aetiopathogenic factors underlying recurrent pregnancy loss (RPL) and the current diagnostic algorithms for its management.
This paper provides an overview of the current medical literature regarding the evolution of views on the diagnostic criteria for recurrent pregnancy loss (RPL) and presents an analysis comparing the diagnostic criteria for recurrent pregnancy loss established by international societies. The analysis indicates that doctors are currently advised to rely on their own clinical judgement and to order a comprehensive examination following two first-trimester miscarriages if there is a suspicion that the miscarriages are pathological rather than sporadic in nature. It is now recommended that the examination should include screening for genetic factors (parental karyotype) and antiphospholipid syndrome (screening for lupus anticoagulant, anticardiolipin antibodies and antibodies to β2-glycoprotein I), an assessment of uterine anatomy (sonohysterography, hysterosalpingography and/or hysteroscopy), determination of hormonal and metabolic factors (screening for thyroid dysfunction or prolactin levels), as well as lifestyle factors. Screening for hereditary thrombophilia is recommended to be carried out within the framework of a research study due to the high cost of such testing worldwide.
No conflict of interests was declared by the authors.
Keywords: pregnancy, recurrent miscarriages, genetic testing, thrombophilia, hormonal disorders, chromosomal abnormalities, uterine malformations, diagnostic criteria.

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