Thyroid, Breast, Endocrine & Cancer Surgeon
Obstetrician, Gynecologist & Laparoscopic Surgeon
Traditionally, recurrent miscarriage is when a woman experiences three or more miscarriages in a row. But today experts recommend a medical evaluation after two recurrent miscarriages. Nearly one to two percent of women suffer recurrent miscarriage
Miscarriage is the natural or spontaneous end of a pregnancy at a stage where the embryo or the fetus is incapable of surviving, generally defined at 20 weeks of pregnancy. Miscarriage is a common complication of pregnancy, and may occur in one of six clinical pregnancies. Many more miscarriages may occur before a woman even knows she is pregnant. A majority of these preclinical miscarriages are due to a random chromosome error.
When experiencing a miscarriage, patients may struggle with feelings of depression, loss, grief and anger. Psychological support can help these patients to cope up with the emotional issues they may have to deal with.
At our center we give one to one care to couple giving them psychological support along with evidence based treatment
Probable Causes of Recurrent Miscarriage
Abnormal Uterine Cavity
⇒ Septums, polyps, "fibroids", adhesions
⇒ Diagnosed by hysterosalpingogram, sonohysterogram, or hysteroscopy
⇒ Treated by surgery (outpatient usually)
Abnormal Chromosomes of Parents
⇒ Can lead to pregnancies with abnormal genetic make-up
⇒ Diagnose by blood test of parents for chromosome make-up
Abnormal Immune System
⇒ Inappropriate regulation of immune system compromising growth of pregnancy and placenta
⇒ Diagnosed by blood tests for antiphospholipid antibodies (including anticardiolipin and lupus anticoagulant)
⇒ Treated with low-dose aspirin and heparin
⇒ Abnormal Regulation of Blood Clotting
Genetic abnormalities in the blood clotting system can contribute to miscarriage and pregnancy complications
Diagnosed by blood tests for several genetic abnormalities
Infection
If you have had a late miscarriage, tests such as blood samples and vaginal swabs may be taken at the time to look for any source of infection.
Referral for genetic counseling
If either you or your partner has a chromosome abnormality, you should be offered the chance to see a specialist called a clinical geneticist. They will discuss with you what your chances are for future pregnancies and will explain what your choices are. This is known as genetic counseling.
Monitoring and treatment for a weak cervix
If you have had a miscarriage between 14 and 24 weeks and have a diagnosis of a weak cervix, you may be offered an operation to put a stitch in your cervix. This is usually done through the vagina at 13 or 14 weeks of pregnancy under a general or spinal anesthetic. Your doctor should discuss the surgery with you.
If it is unclear whether your late miscarriage was caused by a weak cervix, you may be offered vaginal ultrasound scans during your pregnancy to measure the length of your cervix. This may give information on how likely you are to miscarry. If your cervix is shorter than it should be before 24 weeks of pregnancy, you may be offered an operation to put a stitch in your cervix.
Hormone treatment
Taking progesterone or human chorionic gonadotrophin hormones early in pregnancy has been tried to prevent recurrent miscarriage. More evidence is needed to show whether this works.
Immunotherapy
Treatment to prevent or change the response of the immune system (known as immunotherapy) is not recommended for women with recurrent miscarriage. It has not been proven to work, does not improve the chances of a live birth and may carry serious risks (including transfusion reaction, allergic shock and hepatitis)
