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Recurrent Miscarriages: Everything You should Know

Team AckoFeb 8, 2024

Recurrent pregnancy loss is classically defined as two or more consecutive loss of pregnancies. A clinically recognized pregnancy that is ending up involuntary before the 20th week is a pregnancy loss. Clinically recognized means the pregnancy, which is visualized in the ultrasound or the tissue was identified in the female's womb after the abortion takes place.

Contents

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Causes

The abnormality may come from the sperm or the egg or the embryo. Approximately, 12 to 15 percent of the clinically recognized pregnancies end up in abortion. Up to 50 percent of the abortions occur before the 12th week when the females do not even realize that they are pregnant.

The risk increases with the number of pregnancy losses in the past.

Advancing age of the mother may also be associated with the risk of abortion, which is due to a poorer egg quality or any other abnormality that occurs with age. Sometimes both the mother and the father have a slight irregularity in their genes and that results in the severity in their offspring and thus, results in abortion.

The abnormality in the uterus or the deformity of the uterus may lead to miscarriage. This is because of a poor blood supply to the embryo or the inflammation. The human immune system also plays an important role in pregnancy loss as thyroid disease and diabetes increase the risks of a miscarriage. Abnormalities with blood clotting of parents can also be a cause.

Diagnosis

Now before treatment, tests need to be done to find out the reason behind the miscarriages. First of all, the physician will take a detailed history, such as medical, familial, surgical and genetic. Tests such as the karyotype may be done on the parents. A karyotype is the chromosomal component or the genetic makeup of a person. The purpose is to find out any abnormalities that could be passed to the embryo and resulting in the abortion. These abnormalities are very rare so the doctor may choose it as his last choice to find out the reason.

The deformities or the abnormalities in the uterus may be another reason that leads to miscarriages. For that, the uterine cavity will often be evaluated. To evaluate, tests like ultrasound, saline ultrasound or hysterosalpingogram X-ray, MRI or hysteroscopy is used. Ultrasound is the first test that is often done in the first instance. This will provide information about the shape of the uterus or any type of fibroids present in the uterus.

Saline ultrasound is done by injecting the solution in the uterus. A hysterosalpingogram is the x-ray of the uterus that tells us about the well being of the uterus tubes. A hysteroscopy is a minor surgical procedure in which a camera is placed in the uterus through the cervix. In this way, a doctor can easily visualize the inside of the uterus and also see if any polyps and fibroids present. The doctor can also resect a septum or a scar tissue present easily by this method.

Antiphospholipid antibodies, especially anticardiolipin antibody and lupus anticoagulant will likely be checked. These may be related to the antiphospholipid syndrome, that is further related to the pregnancy loss. Any women with pregnancy loss beyond 10th weeks and with regular three miscarriages should be screened.

Treatment

The couples in whom karyotyping is found are referred for genetic counseling where it is been discussed that what is a genetic abnormality and what are the chances in the future of having an abnormal child. Some couples go for the prenatal genetic studies to find out the chromosomal defects by the methods as chorionic villus sampling in which the piece of the placenta is tested in the first trimester for any abnormalities or amniocentesis, which involves the removal of the amniotic fluid for analysis. IVF and other treatments are also available to help couples who are struggling with infertility.

Disclaimer: This content is for informational purposes only, based on industry experience and secondary sources. It is not a substitute for professional advice. Please consult a qualified expert for health or insurance-related decisions. Content is subject to change, refer to current policy wordings for specific ACKO details.

 

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