# Venous Hemodynamic Dysfunction and Recurrent Miscarriage: Case Series and Literature Review

## TL;DR

This study suggests that venous hemodynamic dysfunction may be linked to recurrent miscarriage and could be a target for preconception treatment.

## Contribution

The study links venous hemodynamic dysfunction to recurrent miscarriage and proposes preconception treatment as a novel management pathway.

## Key findings

- Six out of nine women with recurrent miscarriage had preconception venous hemodynamic dysfunction.
- The findings align with existing data on reduced venous reserves in women with recurrent miscarriage.
- The study supports a link between recurrent miscarriage and chronic cardiovascular disease.

## Abstract

(1) Background: Maternal venous hemodynamic dysfunction is an intrinsic part of the pathophysiology of pre-eclampsia and fetal growth restriction. The aim of this study is to evaluate whether venous hemodynamic dysfunction is present in women with a history of (unexplained) recurrent miscarriage, and to link this pilot observation to reported data in the literature. (2) Methods: A retrospective search of hospital records was conducted to find data on recurrent miscarriage and hemodynamics assessment prior to conception. We also performed a scoping search of the literature regarding the association between recurrent miscarriage and maternal hemodynamics, reproductive outcomes, maternal complications, neonatal complications, and long-term cardiovascular function in women and their offspring. (3) Results: Six out of nine women with a history of recurrent miscarriage had preconception venous hemodynamic dysfunction. This observation is in line with the reported data on reduced venous reserves in association with low plasma volume in women with recurrent miscarriage, and adds to the reported link between recurrent miscarriage, poor reproductive outcomes, and chronic cardiovascular disease. (4) Discussion: This retrospective observational cohort supports an association between venous hemodynamic dysfunction and recurrent miscarriage that is corroborated by data reported in the literature. Abnormal venous hemodynamic function can be improved before conception, and this opens a new and currently unexplored pathway in the management of recurrent miscarriage.