Question:hard
H/o recurrent abortions at 8, 11 & 22 weeks. Cardiac activity is normal in all the three. H/o preeclampsia in last pregnancy. What is the most probable cause?
H/o recurrent abortions at 8, 11 & 22 weeks. Cardiac activity is normal in all the three. H/o preeclampsia in last pregnancy. What is the most probable cause?
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Look for the pattern of progressively later gestational age losses -- this is described by a specific law related to one infection.
Updated On: Jun 23, 2026
- Syphilis
- APLA
- TORCH
- GDM
Show Solution
The Correct Option is A
Solution and Explanation
Pattern recognition: Recurrent pregnancy losses at 8, 11, and 22 weeks -- each successive loss occurs at a later gestational age. Cardiac activity was present in all fetuses (ruling out aneuploidy).
Kassowitz Law (Syphilis):
In untreated maternal syphilis, as pregnancy number increases, the gestational age at which pregnancy loss occurs also increases progressively. This law perfectly explains the ascending pattern: 8 wks $\to$ 11 wks $\to$ 22 wks.
Key rule to remember: Among all infections, $\textbf{only syphilis}$ causes recurrent pregnancy loss. TORCH infections do NOT cause RPL and TORCH testing has no role in RPL workup.
Why not APLA? APLA causes either 3+ losses before 10 weeks OR 1+ loss after 10 weeks -- does not follow a Kassowitz pattern.
\[\boxed{\text{Syphilis (Kassowitz Law)}}\]
Kassowitz Law (Syphilis):
In untreated maternal syphilis, as pregnancy number increases, the gestational age at which pregnancy loss occurs also increases progressively. This law perfectly explains the ascending pattern: 8 wks $\to$ 11 wks $\to$ 22 wks.
Key rule to remember: Among all infections, $\textbf{only syphilis}$ causes recurrent pregnancy loss. TORCH infections do NOT cause RPL and TORCH testing has no role in RPL workup.
Why not APLA? APLA causes either 3+ losses before 10 weeks OR 1+ loss after 10 weeks -- does not follow a Kassowitz pattern.
\[\boxed{\text{Syphilis (Kassowitz Law)}}\]
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