HABITUAL ABORTION Also known as RECURRENT PREGNANCY LOSS( RPL) Recurrent pregnancy loss (RPL), also referred to as recurrent miscarriage or habitual abortion, is historically defined as 3 consecutive pregnancy losses prior to 20 weeks from the last menstrual period. CAUSES CHROMOSOMAL-- Genetic problems resulting in an abnormality of the developing fetus can be a major cause of miscarriage. Either partner or even both may be genetically predisposed to passing on a abnormality to the fetus. Some studies report that 50-60% of all miscarriages in the first three months of pregnancy are due to chromosomal abnormalities. ABNORMAL HORMONAL LEVELS --Miscarriage can also occur when the uterine lining does not develop sufficiently. The end result is the fertilized egg risks not having the best environment for implantation and nourishment. This can be attributed to abnormal hormone levels. Women with Thyroid and Adrenal Gland problems and women with Diabetes are usually at a higher risk for miscarriage due to hormonal imbalances. In addition, an elevated prolactin level can also disrupt normal uterine lining development. STRUCTURAL DEFECTS IN THE UTERUS--Structural problems or the shape of the uterus may cause miscarriage, usually by interfering with the implantation of the fertilized egg.Uterine fibroids, are non-cancerous growths in the uterine wall. Fibroids can cause infertility if they are blocking the opening of the Fallopian tube(s) or if their position is affecting the normal functioning of the uterine lining. A septum, (a fibrous wall which divides the uterine cavity), can cause poor implantation and easily pregnancy loss. CERVICAL ISSUES-- Another cause of miscarriage is anINCOMPETANT CERVIC, meaning the cervical muscle is weakened and cannot remain closed as the developing fetus grows and reaches a certain weight which puts pressure on the cervical opening. INFECTIONS--Infections such as German measles (rubella), herpes simplex,  cytomegalo virus and chlamydia can affect fetal development and in some cases, result in miscarriage. IMMUNOLOGICAL CAUSES--One category of immunologic problems that can cause miscarriages are the antiphospolipid antibodies. Blood tests are used to detect the presence of these antibodies. INVESTIGATIONS BASIC---- Detailed obstetric and family history, age, basic blood test like hemogram, BSL, TSH levels IMMUNOLOGIC TEST-----Your blood can be checked for high levels of the antiphospholipid (aPL) antibody and lupus anticoagulant. These aPL antibodies are known to increase the chance of blood clots and change the way the placenta attaches. These blood clots and changes can reduce the blood supply to the foetus, which can cause a miscarriage. TRANSVAGINAL SONOGRAPHY--- is done to find any uterine structural anomaly and see for cervical incompetence. KARYOTYPING OF BOTH HUSBAND AND WIFE HYSTEROSCOPY---- is done to diagnose any intrauterine problems. TREATMENT TO TREAT THE CAUSE either by antibiotics( for infection) or by surgery if needed. To continue-----