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Repeated Miscarriage

Miscarriages are common, occurring in 15-20% of all pregnancies, usually in the first trimester (up to 12 weeks).  A diagnosis of recurrent pregnancy loss (RPL) could be considered after the loss of two or more pregnancies.
Types of Miscarriage:
Early Miscarriage: Miscarriage occurring within 12 weeks of pregnancy.  Most commonly due to genetic or chromosomal problems of the embryo, with 50-80% of spontaneous losses having abnormal chromosomal number.  Problems of uterus like adenomyosis or endometritis can also contribute to early miscarriage.
Late miscarriage: results mainly due to structural abnormalities of uterus, autoimmune problems of the mother or an incompetent cervix.
Finding a cause
A history of recurrent miscarriage calls for evaluation and management.  Tests are done on mother, father and fetal tissue (when possible).
Repeated miscarriages can happen because of any of the following:

  • Chromosomal abnormalities (increased aged of the parents, genetic problems of the parents or the fetus itself)
  • Immune problems
  • Metabolic and Endocrine issues (Polycystic Ovary Syndrome, Thyroid dysfunction, Prolactin disorders, luteal phase defects, Diabetes mellitus, Hyperhomocyteinemia, decreased Vitamin D levels)
  • Antiphospholipid antibodies
  • Problems in the uterus (infections, structural defects, adenomyosis, fibroids)
  • Physical Illness
  • Life style of the woman (excess use of alcohol, caffeine, smoking, obesity and high stress levels)
  • Environmental factors like exposure to certain chemicals, drugs , X- rays, etc.

Emotional Support
Often, the reasons are unknown about multiple miscarriages.  Even after 2 miscarriages, there is high chance of a successful pregnancy even without any specific treatment and with just reassurance!! Be strong and hopeful and consult a doctor who has specialization in high risk obstetric care.

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