Recurrent Miscarriage Treatment
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Frequently Asked Questions – Recurrent Miscarriage Testing
Unfortunately, around 15-20% of detected pregnancies end in a miscarriage and around 1% of couples suffer recurrent miscarriages. Although you may experience spotting, bleeding or abdominal pain when miscarrying, some women have no symptoms, and they only discover their pregnancy ended during a routine ultrasound. Even though a miscarriage is an upsetting and frightening experience, understanding more about pregnancy loss can help you during this difficult time and it is reassuring to know that the majority of couples go on to have a healthy pregnancy following their loss.
What Causes Miscarriage?
Although understanding why you had a miscarriage may help you to come to terms with your loss, it isn't always possible to pinpoint why it happened. However, it is helpful to know that miscarriages rarely occur as a result of anything you or your partner did or did not do. The most likely causes of pregnancy loss are as follows:
Genetic abnormalities prevent your baby from developing as it should, so it is unable to survive. As genetic problems are more common as maternal age increases, this explains why pregnancy loss is more common among the over 35s.
If a hormonal problem causes you to have irregular periods, such as polycystic ovaries, you are at greater risk of miscarrying.
Blood clotting disorders can affect the blood vessels supplying your placenta, particularly if you have increased blood clotting.
Although catching a cough or cold doesn't increase your risk of losing a baby, more serious infections do increase this risk.
Sometimes a chronic health problem, such as poorly controlled diabetes or lupus, may result in miscarriage.
Anatomical reasons can also cause miscarriage. For instance, your cervix may be too weak to support your uterus as the pregnancy progresses. Alternatively, if your uterus is irregularly shaped, this may stop your baby's growth. Large fibroids can also cause you to miscarry at a later stage of pregnancy.
Although most women stop smoking and drinking alcohol before conception, these habits increase your risk of miscarrying, as does abusing drugs.
What Tests Are Available to Investigate Miscarriage?
If you suffer at least three miscarriages in succession, it is recommended you undergo investigations to identify the cause of your pregnancy losses. However, if you already have problems affecting your fertility or you have suffered a loss during the second trimester, investigations after a second miscarriage are advisable. It is important to appreciate though that even after testing, a clear cause is not identified in around 50% of cases. Although this can seem frustrating, it is an indication that your next pregnancy has a good chance of continuing without any problems.
A range of tests are available. For example, testing a blood sample will show whether you have one of a range of blood clotting disorders. Alternatively, testing a sample of tissue collected after a miscarriage can identify chromosomal abnormalities, but in many cases, this should not stop you having a healthy pregnancy in the future.
The third type of testing looks for any anatomical issues that may contribute to pregnancy loss. For instance, it is possible to detect an unusually shaped uterus using a 3D ultrasound imaging, a laparoscopy or a hysteroscopy; the third one allows examination of your uterus using a specialist tube inserted via your vagina.
Are There Any Treatments to Prevent Miscarriage?
Although there is no universal treatment to prevent further miscarriage, if tests show a likely cause, there are effective treatments available for a number of these to reduce the likelihood of pregnancy loss, as discussed below:
If you are found to have a condition that makes your blood clot more easily than it should, you can receive a regime of heparin and low-dose aspirin, which together increase your chances of a successful pregnancy to around 70%.
If you suffered a pregnancy loss due to a weakened cervix, your cervix will be monitored with the help of regular scans in subsequent pregnancies. A stitch at around 14 weeks can be inserted under anaesthetic to keep your cervix closed till late in pregnancy. As this option is not suitable for all women, your doctor will guide you as to whether this suitable given your circumstances.
If you need IVF to conceive and have a history of chromosomal abnormalities caused by what is termed a translocation problem, it is possible to screen the embryo before they are implanted into your uterus, only selecting those that are free from abnormalities.