1. Maternal Causes
1.1. demographic conditions
1.1.1. AMA
1.1.2. poverty
1.1.3. obesity
1.2. infections
1.2.1. parvovirus
1.2.1.1. listeria
1.2.1.1.1. CMV
1.3. exposures/trauma
1.3.1. radiation
1.3.1.1. drugs (MTX)
1.4. medical conditions
1.4.1. immune
1.4.1.1. Rh isoimmunization
1.4.2. autoimmune
1.4.2.1. SLE
1.4.2.1.1. APA syndrome
1.4.3. hormonal
1.4.3.1. DM
1.4.3.1.1. Thyroid
1.4.4. CV/renovascular
1.4.4.1. Chr HTN
1.4.4.1.1. Pre-Eclampsia/Eclampsia
1.4.5. hematologic
1.4.5.1. thrombophilias
2. Obstetric Causes
2.1. Multiple Gestation
2.1.1. TTTS
2.2. Uterus
2.2.1. cervical insufficiency
2.2.2. uterine anomalies
2.2.2.1. septum
2.2.3. uterine rupture
2.3. Placenta
2.3.1. umbilical cord
2.3.1.1. "accident"
2.3.1.2. vasa previa
2.3.1.2.1. velamentous insertion
2.3.1.3. prolapse
2.3.1.4. thrombosis
2.3.2. abnormal placentation
2.3.2.1. poor implantation
2.3.2.2. ectopic
2.3.2.3. dysmaturity/proloned pregnancy
2.3.2.4. abruption
2.3.2.5. fetomaternal hemorrhage
2.3.2.6. insufficiency
3. Epidemiology
3.1. ~6/1000LB
3.2. stable rate over last 20 yrs
3.3. 2x higher in AfrAm
4. Fetal Causes
4.1. chromosomal
4.1.1. monosomies
4.1.1.1. 45X
4.1.2. trisomies
4.1.2.1. Tr16
4.1.2.1.1. Tr22
4.1.3. polyploidy
4.1.3.1. triploidy
4.2. genetic
4.2.1. hemoglobinopathy
4.2.1.1. alpha-thalassemia
4.2.2. New node
4.3. congenital anomalies
4.4. infections
5. Definitions
5.1. developmental
5.1.1. embryonic (6-9wks) + pre-embryonic / anembryonic (2-5wks)
5.1.1.1. majority of pregnancy losses (30% of all clinically recognized pregnancies)
5.1.2. fetal (10-40wks)
5.1.2.1. minority of pregnancy losses (5% of all on-going pregnancies are lost after 10wks)
5.2. historical/clinical
5.2.1. abortions (< 20wks)
5.2.1.1. late (>10wks)
5.2.1.2. early (<10wks)
5.2.2. stillbirths (> 20wks)
5.2.2.1. some states use >24wks
5.2.2.2. WHO Classification = >20wks or 500g