Recurrent pregnancy loss/abortions is defined as two or more consecutive spontaneous pregnancy losses. About 1 % of couples trying to have children are affected by recurrent miscarriage
MOST COMMON CAUSES OF RECURRENT PREGNANCY LOSS
- Chromosomal disorders-chromosomal problem (aneuploidy and translocation )of one or both partners can lead to recurrent miscarriages
- Endocrine disorders-Hypothyroidism and diabetes mellitus leads to increased miscarriages.women with Polycystic ovarian syndrome ( PCOS ) have higher loss rates related to hyperinsulinemia and excess androgen. Inadequate production of progesterone may set the stage for recurrent miscarriages.
- Blood clotting disorders-Thrombophilia, Factor V Leiden gene mutation may lead to increased risk of miscarriage
- Antiphospholipid syndrome is an autoimmune disease that is a common cause of recurrent miscarriages
- Anatomical cause-the structure of the uterus and cervical incompetence may cause premature pregnancy losses
- Infections-Maternal infections such as toxoplasmosis, rubella, herpes, cytomegalovirus, measles can lead to recurrent miscarriages
- Unexplained causes
- Less common causes include long time exposure to smoking, alcohol and drugs.
HOW TO MANAGE
INVESTIGATIONS REQUIRED
- USG -TRANS VAGINAL SONOGRAM TO DETECT anatomical abnormalities and congenital malformations of the uterus.
- Parental karyotype to detect chromosomal problems
- Blood tests for thrombophilia and antiphospholipid syndrome
- Thyroid function and blood sugar tests
- Tests for screening infections
PREVENTING MISCARRIAGE
- Visit a high-risk obstetrician for preconceptional counselling and regular antenatal checkup
- To start prenatal vitamins (folic acid 5 mg ).
- Optimisation of blood sugar levels and hyperinsulinemia with oral hypoglycemic drugs( Metformin ) has to be done.
- Optimisation of thyroid hormone levels with thyroid medication is essential.
- You may be asked to take low dose aspirin ( 75 mg) in pregnancy.
- Daily subcutaneous injection of low molecular weight heparin ( in case of thrombophilia and autoimmune disease ) may be required.
- In some cases, immunotherapy with immunoglobins may be tried for a better outcome.
- Eat a well-balanced diet.
- Do regular exercise.
- Avoid drugs, smoking, alcohol, and limit caffeine intake.
- Weight management is very essential for a successful pregnancy.
- Avoid stress and maintaining a healthy lifestyle with proper sleep and a positive approach are a key to success in managing recurrent miscarriages.
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