What is miscarriage & recurrent pregnancy loss?
Repeated pregnancy loss is defined as at least 2 confirmed pregnancies lost prior to 20 weeks. Although approximately 15 percent of all pregnancies result in miscarriages, fewer than five percent of women will experience two consecutive miscarriages, and only one to two percent experience three or more miscarriages.
Causes miscarriage & recurrent pregnancy loss
- Age: After age 40, more than one-third of all pregnancies end in miscarriages, most of them due to embryos with an abnormal number of chromosomes.
- Genetic/Chromosomal : If one or both parents carry a chromosomal or genetic abnormality, this may be passed on to a developing embryo and cause pregnancy loss. These affect 3-8% of all pregnancies.
- Anatomic: this include abnormalities in the uterus and cervix. If the uterus contains a septum (wall of tissue) or any distortion in its cavity, implantation of an embryo will be difficult and pregnancy loss may occur. These account for 10 to 15 percent of women with recurrent pregnancy loss. Also, uterine fibroids or scarring from previous surgical procedures may cause pregnancy loss.
- Immunologic: The presence of antibodies that are seen in women with lupus and rheumatoid arthritis and other rheumatologic conditions may cause miscarriage.
- Infection: Certain cervical and uterine infections may increase the likelihood of pregnancy loss.
- Thrombotic blood clotting: Problems can lead to reduced blood supply to the developing fetus.
- Metabolic: Women with poorly controlled diabetes and polycystic ovarian syndrome have higher rates of miscarriage.
- Unexplained: There is no obvious explanation for up to 50 percent of couples with recurrent pregnancy loss.
Symptoms of miscarriage & recurrent pregnancy loss
- Light bleeding that turns into heavy bleeding
- Passing tissue that either looks like blood clots or is pink/gray in color
- Abdominal pain
- Severe cramps
- Back pain
A small amount of cramping or slight spotting may occur during a normal pregnancy, which does not necessarily signal a miscarriage.
Treatment for miscarriage & recurrent pregnancy loss
- Genetic or chromosomal abnormalities in the prospective parents are only diagnosed by blood tests. These chromosome or genetic abnormalities in one or both parents may be addressed through preimplantation genetic diagnosis (PGD), preimplantation genetic screening (PGS) or Comparative Genomic Hybridization (CGH) of an embryo that has been fertilized through in vitro fertilization (IVF) techniques.
- Anatomic abnormalities can be corrected by surgery, sometimes with significant improvement in pregnancy rates.
- Women with diabetes improve pregnancy outcomes if the blood sugar level is controlled before conception.
- Quitting smoking, reduced alcohol and caffeine intake, exercise and weight control, and folic acid supplementation, or frequent ultrasound scans at the beginning of pregnancy, may benefit women suffering from recurrent pregnancy loss.