Gestational loss is a frequent complication of pregnancy, with a significant physical and emotional impact on women and their partners. Despite its high incidence, many patients do not have a clear, agile and homogeneous care pathway that integrates diagnosis, treatment and emotional support in a coordinated manner. For this reason, at the Hospital de la Santa Creu i Sant Pau we have created the Functional Reproductive Loss Unit (UPR), with the aim of offering comprehensive, personalized and value-based care, through a multidisciplinary approach that guarantees quality of care, efficiency and continuous accompaniment.
Objectives
- To provide comprehensive, personalised and women-centered care in the face of early reproductive losses, incorporating both the clinical and emotional dimension.
- To optimise the diagnosis of underlying causes through coordination between specialties and the use of specific tests according to established protocols.
- To define a cconsensus-based therapeutic plan grounded in scientific evidence and standardized criteria, thereby reducing unnecessary clinical variability.
- To provide emotional support and ensure access to psychological care throughout the treatment process when necessary.
- To implement a system of therapeutic monitoring and follow-up that facilitates adherence to treatment, the planning of future pregnancies and the prevention of new losses.
- To promote the measurement of clinical results and satisfaction, and promote the continuous improvement of care pathways and the quality of care.
- To promote teaching and research, contributing to the generation of expert knowledge and new management strategies in this field.
Equipment and Services that are part of it
The approach to reproductive loss (UPR) requires the coordinated participation of different specialties to guarantee a transversal response, avoid diagnostic duplications and reduce the time between the first assessment and the therapeutic proposal. The UPR is a transversal and multidisciplinary functional unit that integrates professionals from the main services involved in the diagnosis and treatment of women with repeat abortions, ensuring a more efficient care pathway and consistent information for patients.
These are the specialties that are part of it:
- Gynecology and Obstetrics Service: Dr. Cristina Trilla (Coordinator), Dr. Judit Platero, Dr. Josep Estadella
- Reproductive Medicine: Dr. Beatriz Alvaro and Dr. Sofia Gaggiotti
- Endocrinology and Nutrition Service: Dr. Lilian Mendoza
- Immunology Service: Dra. Teresa Franco and Dra. Esther Moga
- Genetics Service: Dr. Anna Abulí and Dr. Olaya Villa
- Hemostasis/Hematology Service: Dr. Marina Carrasco
- Biochemistry Service: Dr. Madalina Nan
- Clinical Psychology Service: Clara Mercadé
- Andrology Service (Fundació Puigvert): Dr. Maurizzio De Rocco
- Department of Nursing: Maria LLavoré
Multidisciplinary sessions and committees
The Reproductive Loss Committee serves as the central forum for joint case evaluation, with the aim of defining a personalized diagnostic and therapeutic strategy and coordinating decision-making among specialists. At a minimum, representatives from the core specialties of the unit participate, and other professionals may join according to the clinical needs of each patient.
The UPR Committee meets on alternate Mondays from 12:30 p.m. to 2:00 p.m. and reviews all cases managed by the unit to ensure a multidisciplinary assessment and to agree on the diagnosis, therapeutic plan, and follow-up care.
Research and training
The Functional Reproductive Loss Unit promotes active research initiatives aimed at improving patient care and deepening understanding of the biological mechanisms involved in gestational loss. Currently, the unit is supported and funded through a competitive grant from the Carlos III Health Institute (ISCIII):
FIRST-CARE Study (PI24/01753): Comprehensive assessment of first-trimester gestational loss, analyzing its impact and biological pathways to develop personalized management and care strategies.
From an educational perspective, the UPR is organizing the first iCARE course, dedicated to the comprehensive approach to recurrent pregnancy loss, scheduled for June 2026, with the goal of becoming a benchmark training program and promoting the continuous professional development of specialists in this field.
