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australia clinical guidance

Recurrent miscarriage

A detailed Australian summary of recurrent miscarriage, with source-attributed priorities, a practical workflow, safety escalation and state or territory implementation boundaries.

JurisdictionAustralia
Source check2026-08-20
Clinical reviewiatroX editorial team 路 Clinical editorial review 路 reviewed 2026-08-20 路 due 2027-08-20
AudienceHealthcare professionals practising in Australia
This is an iatroX educational summary of named Australia sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. Apply current TGA product information, PBS restrictions, state or territory law, local referral criteria, formulary and antimicrobial policy. A national recommendation does not create uniform service access.

Scope

RANZCOG defines recurrent miscarriage within its 2025 guideline; use that Australian definition rather than importing a different jurisdictional threshold. Take a detailed pregnancy timeline and assess uterine anatomy, antiphospholipid syndrome and selected parental or endocrine factors under the guideline. This summary is limited to the population, decisions and escalation boundaries stated in the named source.
sources for this section:RANZCOG C-Gyn 38

The Bottom Line

  • RANZCOG defines recurrent miscarriage within its 2025 guideline; use that Australian definition rather than importing a different jurisdictional threshold.
  • Take a detailed pregnancy timeline and assess uterine anatomy, antiphospholipid syndrome and selected parental or endocrine factors under the guideline.
  • Antiphospholipid testing requires persistent antibodies on appropriately separated tests before diagnosing the syndrome.
  • Avoid unsupported immune, thrombophilia and infection panels and treatments where evidence does not show benefit.
sources for this section:RANZCOG C-Gyn 38

Practical clinical workflow

1

Topic-specific assessment action

RANZCOG defines recurrent miscarriage within its 2025 guideline; use that Australian definition rather than importing a different jurisdictional threshold.
2

Topic-specific diagnostic action

Avoid unsupported immune, thrombophilia and infection panels and treatments where evidence does not show benefit.
3

Topic-specific management action

Provide continuity, early ultrasound and psychological support and explain that many couples have a subsequent live birth even when no cause is found.
4

Topic-specific follow-through

Routine inherited thrombophilia testing is not recommended without a separate thrombotic indication under the guideline.
sources for this section:RANZCOG C-Gyn 38

Safety boundaries and escalation

  • Active pregnancy pain, heavy bleeding, syncope, fever or pregnancy of unknown location requires immediate ectopic, haemorrhage and sepsis assessment.
  • Parental karyotype and products-of-conception testing should be targeted because results do not always explain recurrence or change care.
sources for this section:RANZCOG C-Gyn 38

Implementation

The named source is national or binational guidance used in Australia, but referral access, public-health directions, formularies and funded services can still differ by state, territory and health service. Check current TGA product information for medicines. Offer culturally safe care and use the NACCHO鈥揜ACGP National Guide where Aboriginal and Torres Strait Islander preventive or chronic-care recommendations differ.
sources for this section:RANZCOG C-Gyn 38

Clinical use boundary

This independently written summary is not an official guideline. Check the linked source version, current TGA-approved product information where medicines are involved, and the applicable state, territory and local pathway at the point of care.

sources for this section:RANZCOG C-Gyn 38

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. Royal Australian and New Zealand College of Obstetricians and GynaecologistsMiscarriage, Recurrent Miscarriage and Ectopic Pregnancy (C-Gyn 38)C-Gyn 38 路 2025 clinical guidance 路 accessed 2026-08-20
    view source
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