Recurrent miscarriage (RM) is a challenging clinical condition accentuated by a multi-factorial aetiology. Recent research has afforded us an in-depth understanding of the complexities of the evolving pregnancy and of the potential hazards that it may face at different developmental stages. A delineation of types of pregnancy loss provides a useful framework in the management of RM. New theories have highlighted the impact of a hostile endometrium, chromosomal aberrations, abnormal immune responses and hormonal influences on recurrent pregnancy loss. Whilst the antiphospholipid syndrome retains its importance as a significant aetiology in RM, recent attention has focused on the role of other hereditary and acquired thrombophilias. As far as mid-trimester losses are concerned, the entities of cervical weakness and bacterial vaginosis are prominent features.
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