Recurrent Miscarriage
Miscarriage is the spontaneous loss of pregnancy before the 20th week and is one of the most common complications of pregnancy. Two or more consecutive pregnancy losses is termed as recurrent miscarriage.
Causes
Pregnancy losses may be caused by the following:
- Genetic abnormality
- Abnormalities in egg, sperm or early embryo
- Abnormalities in the uterus or womb, such as fibroids (lumps)
- Anti-phospholipid syndrome (APS): production of antibodies by the immune system that attack fat cells in blood, leading to clot formation
- Hormonal abnormalities: Polycystic ovarian syndrome, uncontrolled diabetes
- Immune system problems
- Bacterial infections in the vagina
The following are factors that could increase your risk for recurrent miscarriages:
- You and your partner are above the age of 35
- You are overweight or underweight
- Previous pregnancy loss
Diagnosis
Your physician initially performs a detailed medical and physical examination and reviews your family and genetic history. Several different tests are used for the diagnosis of recurrent miscarriage:
- Karyotype testing (testing of the genetic makeup) of both partners to find abnormalities that can pass on to the offspring, which could result in repeated miscarriage
- Uterus is evaluated using ultrasound scans and imaging techniques to detect the presence of fibroids
- Anti-phospholipid antibodies are evaluated to check for APS
- Hormone function tests and thyroid function tests to check for abnormalities in hormonal levels
- Ovarian reserve tests to check the functioning of the ovaries
Treatment
Treatment for patients with recurrent pregnancy loss is based on the cause of the miscarriage. If you have a genetic cause, you will be recommended genetic counselling, where you are counselled about the genetic abnormality and the possibility of having a normal pregnancy in the future. Prenatal genetic studies may be performed during pregnancy to check the genetic makeup of the offspring. In cases of uterine abnormality, you may be recommended for surgery. Medications may be prescribed to treat miscarriages related to APS, diabetes, thyroid or hormonal problems.
