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The research behind the Tender Loving Care (TLC) approach for Recurrent Pregnancy Loss

As promised after looking at the results of my survey. I wanted to share research from an ‘old’ study that proposed supportive care or Tender Loving Care (TLC) for women with unexplained recurrent pregnancy loss really helps with their subsequent pregnancy.

The research was published by Clifford and co-authors in 1997 from St. Mary’s Hospital, London, England (where I worked as a ObGyn resident a long time ago). At St. Mary’s hospital they have a dedicated recurrent pregnancy loss clinic, which I have used to model my own clinic.

In this study, women with unexplained (i.e. no known reason for miscarriages) recurrent pregnancy loss (3 or more consecutive first trimester/early miscarriages) were offered to attend the dedicated early pregnancy unit, staffed by three physicians, where they would be seen for fetal viability scan, then weekly for serial ultrasounds and fetal growth until 12 weeks gestation. No medication was given so entirely supportive care only. The researchers then looked at the pregnancy outcomes of women who attended the early pregnancy unit and those who declined. Interestingly, of the 160 women who opted to attend the early pregnancy unit, 42 women had a subsequent miscarriage (26% miscarriage rate), whereas women who declined going to the early pregnancy unit had a higher miscarriage rate of 51% (21/41 women). This result was highly significant and has led to the routine use of the Tender Loving Care (TLC) approach for women who have experienced recurrent pregnancy loss. As a researcher, I’m so curious to understand how does supportive care help with reducing miscarriages?

For those who are reading this, the take home message is discuss with your Ob or REI physician whether they can provide you with the TLC protocol, as it could be helpful for you.