ABSTRACT
Preconception counseling plays a key role in preparing for a pregnancy. In couples
with a history of recurrent early pregnancy loss, counseling is of particular importance
because women are invariably more distressed and require reassurance that everything
possible is being done to avoid future pregnancy losses. Because their subsequent
pregnancies are more likely to be planned and these patients may be more willing to
adopt recommendations that have been offered to them, it becomes more important to
identify which investigations and interventions are the most beneficial. Several interventions
ranging from genetic testing to lifestyle changes and medications may have a positive
effect on the chances of a successful pregnancy. Early pregnancy monitoring and support
increases the chance of a live birth and helps to predict potential future pregnancy
complications. Recent research suggests that events that occur in the uterine decidua,
even before a woman knows she is pregnant, may have a significant impact on fetal
growth and the outcome of pregnancy. With this in mind, shifting future research and
clinical practice to focus on the periconceptual period and the very early stages
of pregnancy should offer significant benefits to the health of both the mother and
her infant. The overall aim should be to effectively use every pregnancy as the health-care
opportunity of two lifetimes.
KEYWORDS
Early pregnancy - preconception counseling - recurrent pregnancy loss
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Lesley ReganM.B.B.S. M.D. F.R.C.O.G.
Department of Obstetrics and Gynaecology, St. Mary's Campus, Imperial College London
Mint Wing, South Wharf Road, London W2 1PG, UK
eMail: l.regan@imperial.ac.uk
