What are recurrent miscarriages? Causes, diagnosis and treatment

A miscarriage is the death of an embryo before it has evolved sufficiently to survive, which is commonly before 24 weeks of pregnancy. Recurrent miscarriages are often defined as two or three miscarriages in a row or the loss of three or more pregnancies before 24 weeks with no successful pregnancies in between.

What are the causes of recurrent miscarriages?

There are no absolute causes for recurrent miscarriages; however, to help you understand these causes better, some of them are listed below.

• Womb abnormalities in pregnant women: Long-term infection, a scar of the uterine lining, or an odd shape are some examples of womb abnormalities. Up to 19 out of every 100 women who have recurrent miscarriages have some kind of womb abnormality.
• A weakened cervix, also known as cervical insufficiency: The cervix usually only expands during labour to allow the baby to come out. In some women, the cervix is weak and opens unexpectedly.
• Antiphospholipid Syndrome (APS): This is an immune system defect that causes blood to clot more easily than usual. This can have an impact on the blood flow to the placenta and the growing foetus. APS affects 5 to 20 women out of every 100 who experience recurrent miscarriages.
• Hormone imbalances: Hyperprolactinaemia and low thyroid hormone levels (hypothyroidism) can both impact the hormones required to maintain pregnancy. 

What are the tests required for recurrent miscarriages?

• Ultrasound scan: It is to detect uterine abnormalities. If you have experienced miscarriages late in past pregnancies, an ultrasound scan may be useful early on to examine the neck of the womb for cervical insufficiency.
• Antiphospholipid Antibody Blood Test: In APS, aberrant antibodies are produced that target a naturally occurring molecule known as a phospholipid. If these aberrant antibodies are detected in a blood test, you may or may not have APS, but you will need to repeat the tests for additional abnormal antibodies. Thus, a single positive test may be unrelated to recurrent miscarriage.
• Hysterosalpingogram (HSG): An x-ray process performed after injecting a dye into the uterus to detect any abnormalities that may be associated with the pregnancy.
• Thyroid Panel: Hypothyroidism is sometimes linked with second-trimester miscarriage. Thyroid tests are commonly carried out as part of a fertility examination since low thyroid levels can cause infertility.
• Progesterone test: Low progesterone levels could result in recurrent miscarriages.
• Karyotype testing: This test is used on both parents to check for genetic issues that might harm the pregnancy.

What is the treatment for recurrent miscarriages?

• If you have APS or other blood clotting issues, you will be advised to take blood-thinning medicines during subsequent pregnancies, often aspirin pills and low molecular weight heparin injections.
• If a curable womb abnormality is discovered, a treatment to fix it may minimise the chance of a subsequent miscarriage. A stitch can be put in early pregnancy to keep the cervix closed for women who have a weak cervix. This may aid in the prevention of a miscarriage.
• If you or your partner are discovered to have chromosomal abnormalities, you will typically be directed to a genetics professional for additional advice. You also have the option of pre-implantation genetic testing, such as with in vitro fertilization (IVF).
• Some pregnancies may put a lot of strain on you and your relationship. Counselling, for example, might be beneficial in such cases.

Who qualifies for the treatment of recurrent miscarriages?

If the problem is with the uterus, you can consider surrogacy, in which another woman agrees to carry your child in her womb. Miscarriages induced by thyroid or other endocrine issues may be cured with hormonal medications, and pregnancy is pursued only when hormone levels are favourable.

If you've undergone IVF but were unsuccessful, the quality of the female eggs might be the reason. If eggs are the issue, see your doctor about IVF using donor eggs.

Conclusion

If you are having difficulty conceiving or have had several miscarriages, you must speak with some of the finest fertility physicians. Different women may suffer from distinct issues. There’s a solution and treatment for all abnormalities. To help you with your problems, we’re here.

Request an appointment at Apollo Cradle, Hyderabad - Kondapur. Call 1860-500-1066 to book an appointment.