Management of Recurrent Pregnancy Loss: Clinical Practices and Patient Experience at Teaching Hospitals in Lagos State

Recurrent pregnancy loss (RPL), defined as three or more consecutive pregnancy losses before 20 weeks, causes significant psychological distress and requires systematic clinical investigation and management, yet the quality of RPL care in Lagos State teaching hospitals has not been professionally evaluated. This study assesses clinical management practices and patient experience in recurrent pregnancy loss at Lagos University Teaching Hospital and Lagos State University Teaching Hospital. A mixed-methods approach combines retrospective case note review of 80 RPL cases over two years and in-depth interviews with 20 women experiencing RPL. Clinical investigations documented, management approaches applied, and patient-reported experience of care were analysed. Complete aetiological investigation was performed in only 44 percent of cases, with antiphospholipid syndrome screening the most consistently omitted (performed in 31 percent). Empirical progesterone prescribing without documented indication was recorded in 58 percent. Patient-reported experience highlighted inadequate emotional support, insufficient explanation of investigation results, and long waiting times between recurrences and review appointments. The study identifies investigative incompleteness and poor patient communication as the primary RPL care quality gaps in the Lagos hospitals. Professional recommendations include structured RPL investigation protocols, dedicated RPL clinics, psychological support services integration, and clinical staff training in patient-centred communication for pregnancy loss. Keywords: recurrent pregnancy loss, management, Lagos, patient experience, antiphospholipid syndrome