Outpatient hysteroscopy in recurrent pregnancy loss

Recurrent pregnancy loss is defined as the loss of three or more consecutive pregnancies. Common causes of recurrent pregnancy loss are endometritis, genetic abnormalities, congenital or acquired uterine malformation, endocrine dysfunction, thrombophilic disorders, autoimmune diseases, incompetent cervix, luteal phase defect, certain infections, and sperm DNA abnormalities. The workup of patients with RPL includes congenital malformation (most commonly bicornuate, didelphic, septate, and unicornuate uteri) and acquired defects (fibroids, adenomas, adhesions, and polyps). Office hysteroscopy plays an important role in the diagnosis and treatment of uterine pathologies associated with RPL. This chapter reviews the structural uterine and endometrial causes of pregnancy loss and the role of office hystyeroscopy, describing hysteroscopic and hystological findings; it also considers legal aspects of complication occurring during outpatient hysteroscopic procedures.