Health Topics » Pregnancy & Motherhood » Repeated Miscarriages   Login

 Pregnancy & Motherhood

October 2010

Repeated Miscarriages

Dr. Vaneet Kaur
15 to 20 percent of all pregnancies result in miscarriages - and they usually occur within first three months of pregnancy.

Miscarriage is a genuine concern for expectant parents. If any woman has three or more miscarriages, it is referred to as repeated miscarriage or habitual abortion. Around one in 100 women have repeated miscarriages and need special care.

Why does it happen?
In many women, no cause may be found; though in some, repeated miscarriages may occur due to some specific underlying causes:
  1. Advanced age: being more than 35 years
  2. Genetic (chromosomal) causes
  3. Autoimmune factors: immune response of the body against substance normally present in the body
  4. Structural defects of the uterus or cervix
  5. Certain blood disorders like thrombophillia (increased tendency of the blood to clot)
It is also important for the couple to know that normal level of exercise, sexual intercourse, lack of sleep or rest, stress, vomiting and minor trauma do not lead to repeated miscarriages.

Whom to Consult
If there is history of three or more miscarriages, the odds of having an underlying cause are high. It is always better to see an obstetrician, who has experience in looking after high-risk pregnancy cases. Most of the obstetricians are familiar with the proven and accepted causes of repeated miscarriage, but if some cause is found out during investigations like genetic or autoimmune cause, it is always better that you are being reviewed by a foetal medicine expert.
If you have undergone repeated miscarriages, it is always better to have prenatal care in an institution, where healthcare providers needed to handle your case are available.

Testing for Repeated Miscarriage
You may have to undergo a few blood tests, to find out the cause for repeated miscarriage.
  • Parental chromosomal analysis is important to find out genetic causes.
  • You may also be tested for the presence of lupus antibodies, which are a marker of autoimmune disorder.
  • Be ready for hysterosalpingography (a procedure where a dye is pushed through the cervix into the uterus), if required.
  • Hysteroscopy (inserting a tiny telescope through the cervix to see inside of the uterus) to find out if there are structural defects of uterus or cervix is also a normal enough procedure.
Still, in many cases, in spite of all such investigations, the reasons for repeated miscarriages might not be found out.

Past Imperfect, Future Tense
  • If your test results indicate a genetic problem in either you or your partner, you can know the exact risk of recurrence. The usual risk is 25 percent or lesser, but can be upto 100 percent in selected conditions, when you may have to go for alternative methods of conception.
  • In case of medical problems like autoimmune diseases or endocrinological disorders, you may need to take some drugs before conception, which may be continued throughout pregnancy.
  • Structural defects of the uterus are usually correctable by surgery, but if that is not possible, the only option may be surrogacy (getting another lady’s womb for your baby to grow in).
It is quite possible that your obstetrician may not be able to tell you for sure regarding the outcome of next pregnancy. Even if one is not able to find out the exact cause for repeated miscarriage, there is still a good chance (one in four) of carrying the pregnancy to term and delivering a normal baby. Most of the miscarriages are preventable so always try to have a positive attitude, eat well and exercise regularly. Prayer might keep you buoyant in spite of your situations. Hopefully, you will be holding a baby in your arms and the distressing experience of miscarriage may soon become a thing of the past.
Dr. Vaneet Kaur is Consultant Gynaecologist at Apollo Hospitals, Ludhiana

 Also See