Recurrent Miscarriages
Recurrent miscarriage is defined as 3 or more consecutive, spontaneous pregnancy losses.
Approximately 20 percent of pregnancies end in miscarriage, which is defined as the loss of a pregnancy before 20 weeks of gestation. Most miscarriages occur within the first 12 weeks of gestation. “Recurrent miscarriage,” also known as “habitual pregnancy loss,” is commonly defined as 3 or more miscarriages. When miscarriage occurs this frequently, there may be an underlying cause such as a genetic defect, an infection, or a condition in which the cervix is too weak to support a fetus (cervical incompetence). Other causes include an abnormally shaped uterus, uterine fibroids that hinder implantation or growth of the fetus, and hormonal imbalances (prolactin, thyroid, and progesterone). Having an illness such as diabetes mellitus or an immune-system abnormality may also cause miscarriage.
Diagnostic tests to determine the causes of miscarriage
Your medical history, a pelvic exam, and one or more of the tests listed below are necessary in diagnosing possible causes of your recurring miscarriages:
- Karyotype—a mapping of your chromosomes, used to diagnose genetic defects
- Hysterosalpingogram—a procedure that uses x-rays and a special dye to evaluate the shape of the inside of your uterus
- Laparoscopy—an outpatient surgical procedure in which your doctor uses a narrow fiber optic telescope inserted through an incision near your navel to evaluate your uterus, fallopian tubes, and ovaries
- Hysteroscopy—a procedure in which your doctor uses a narrow fiber optic telescope inserted into the uterus to look inside your uterine cavity
- Vaginal ultrasound—a scan that uses high-frequency sound waves to detect abnormalities in and around the uterus, ovaries, and fallopian tubes
- Blood hormone levels—blood tests that reveal the levels of certain hormones in your blood, such as prolactin, thyroid, and progesterone
- Endometrial biopsy—a procedure in which a sample of your endometrial tissue is examined under a microscope to determine if it is appropriately developed for an implanting embryo
- Glucose screening—a blood test used to diagnose diabetes mellitus, which, if left uncontrolled, increases the likelihood of miscarriage
- Antibodies tests—blood tests used to detect an immune-system abnormality
Questions & Answers
Q. Are there any risk factors associated with miscarriage?
A. The risk of miscarriage increases with increasing age, especially in women over the age of 35. Smoking, caffeine, and alcohol increase your risk of miscarriage. Also, some medications, including those you can buy without a prescription, may increase your risk.
Q. What treatments are available to me?
A. Treatment will depend on the cause of the miscarriages. If you are diagnosed with cervical incompetence (a condition in which the cervix opens too early because of the baby’s increasing weight), you may require surgery. If you have an infection, you and your partner may be treated with medication. Your doctor can remove uterine fibroids surgically, and can treat hormonal imbalances, diabetes, and immune system abnormalities with medications. Sometimes the cause cannot be determined, and therefore no treatment can be prescribed.
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