Considering the multifactorial nature of recurrent miscarriage and insufficient knowledge of etiopathogenesis, it is possible to establish the root cause of this obstetric pathology only in 50-60% of patients. The study is conducted under the guidance of an obstetrician-gynecologist. If a pregnant woman applied with complaints of pain, spotting, the diagnosis of abortion is first clarified, after which the causes of the complication are clarified. Diagnostic search is carried out using the following methods:
• Physical examination. In the course of a gynecological examination, according to the state of cervical mucus and cervix, uterine tone, threatening, incipient preterm labor or miscarriage can be diagnosed. An analysis of the anamnestic data and the results of a general examination suggests the cause of the pathological condition.
• Ultrasonography. Ultrasound of the uterus makes it possible to diagnose a missed pregnancy, to detect congenital and acquired defects. Outside of gestation, an ultrasound of the ovary (folliculometry) is performed to detect violations of ovarian function.
• Laboratory blood tests. To detect endocrine pathology, studies of the general hormonal status, the level of sex and placental hormones are performed. For the diagnosis of APS and hereditary thrombophilia, a coagulogram, enzyme immunoassay, and PCR analysis are performed. By the method of DNA sequencing of spouses, typing of HLA class II genes, genetic abnormalities in parents are determined, their histocompatibility is assessed.
• Research on infections. During pregnancy, a vaginal smear is examined, outside of gestation - an endometrial biopsy. Cultural analysis allows to identify a nonspecific bacterial infection, to clarify the sensitivity of the pathogen to antibiotics. PCR research is used to diagnose viral and specific bacterial infections.
Additionally, MRI of the pelvic organs, hysteroscopy can be prescribed. Diagnosis is carried out with the involvement of an endocrinologist, immunologist and medical geneticist. Incipient pregnancy loss is differentiated with uterine tumors, ectopic pregnancy, trophoblastic disease, and placenta previa.