Question 1

Q: After an initial pregnancy resulted in a spontaneous loss in the first trimester, your patient is concerned about the possibility of this recurring. What is the chance of recurrence?

Is no different than it was prior to the miscarriage. ### Explanation **Correct Answer: B. Is no different than it was prior to the miscarriage** **1. Why Option B is Correct:** Spontaneous abortion (miscarriage) is a common event, occurring in approximately 10–15% of clinically recognized pregnancies. The vast majority (up to 50–70%) of isolated first-trimester losses are due to **sporadic chromosomal abnormalities** (e.g., autosomal trisomies), which are random events. Statistically, after a **single** spontaneous loss, the risk of a subsequent miscarriage remains approximately **15–20%**, which is essentially the same as the baseline risk for the general population. The risk only begins to rise significantly after two or more consecutive losses. **2. Why Other Options are Wrong:** * **Option A:** While the genetic makeup of the abortus explains *why* that specific pregnancy failed, it does not dictate the recurrence risk for the next pregnancy unless a parental balanced translocation is present (which is rare and not the default assumption after a single loss). * **Options C & D:** These options overestimate the risk. A 50% recurrence risk is not reached even after three consecutive losses. After two losses, the risk rises to ~25–30%, and after three, it reaches ~33–45%. **3. Clinical Pearls for NEET-PG:** * **Most common cause of first-trimester abortion:** Fetal genetic factors (Chromosomal anomalies). * **Most common specific chromosomal anomaly:** Autosomal Trisomy (Trisomy 16 is the most common specific trisomy). * **Recurrent Pregnancy Loss (RPL):** Defined by the ASRM as **two or more** failed clinical pregnancies. Investigations for RPL are generally not indicated after a single isolated loss. * **Prognosis:** Even after 3 losses, the most likely outcome for the next pregnancy is a live birth (approx. 60–70% success rate without intervention).

Question

After an initial pregnancy resulted in a spontaneous loss in the first trimester, your patient is concerned about the possibility of this recurring. What is the chance of recurrence?

Accepted Answer

Is no different than it was prior to the miscarriage

Answer

Depends on the genetic makeup of the prior abortus

Answer

Is increased to approximately 50%

Answer

Is increased most likely to greater than 50%

Reproductive Ethics — MCQs

Reproductive Ethics — MCQs

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