When a prospective mother goes through two or more spontaneous losses in pregnancies, it is known as recurrent miscarriages. 15% of pregnancies can end in miscarriages before 20 weeks of gestation. It is known as a loss of pregnancy. Most of the miscarriages generally occur within the first 12 weeks of gestation. Recurrent miscarriage is also known as 'habitual pregnancy loss', which is 3 or more miscarriages. When miscarriages are occurring very frequently, there could be an underlying genetic cause. The treatment for pregnancy losses could involve anything from prenatal surgery, careful monitoring, antibiotics and hormone therapy.
What are the diagnostic tests that determine the causes of miscarriage?
There are lots of tests that can help to diagnose the possible cause of miscarriage.
- Saline Sonohysterogram - It is a procedure where sterile water is placed in the cavity of the uterus during a transvaginal ultrasound. The procedure shows endometrial cavity abnormalities like fibroids, polyps and scar tissues.
- Karyotype - It maps the chromosomes and diagnoses genetic defects.
- Hysterosalpingogram - The procedure uses X-rays and a special dye and evaluates the shape of the uterus.
- Glucose screening - The blood test that diagnoses diabetes mellitus when left uncontrolled. The likelihood of miscarriage is increased by the condition.
- Endometrial biopsy - It is a procedure when the endometrial tissue is examined under the microscope to determine the presence of an infection preventing the progress of pregnancy.
Why does a miscarriage take place?
Miscarriage is a natural process that protects a woman from an abnormal pregnancy. Most of the losses are based on the chromosomal abnormality of the embryo. Genetic factors could also be preventing the normal development of the embryo.
- Conditions affecting the uterus - The implantation process is regulated by hormones. A synchronised interaction is required between the lining of the woman's uterus and the embryo. The factors that affect this relationship adversely can result in a pregnancy loss. The progesterone hormone is necessary for establishing and maintaining pregnancy. The relationship between the hormonal environment and implantation is very intricate.
- Genetic factors - A genetic problem with one or both the parents could result in recurrent miscarriages. More than 50%-70% of all the miscarriages are attributed to the chromosomal build of the embryo. Most of the errors occur during the oocyte maturation process compared to sperm maturation.
- Problems with the immune system - It is quite evident that there is a relation between the uterus and the immune system. There are two antibodies that promote foetal death - anticardiolipin antibodies (ACA) and lupus anticoagulant (LAC). The abnormalities of some of the white blood functions can also be a potential cause of miscarriage.
- Structural problems with the uterus of the woman - Congenital defects, fibroids and polyps can result in miscarriage or complications later in the pregnancy. An X-ray test or ultrasound test could reveal the structural abnormalities.
- Environmental factors - There is a relation between miscarriages and environmental factors like smoking, alcohol and caffeine use or even vigorous exercise.
- Hormonal disorders - Certain disorders like thyroid disease or uncontrolled diabetes might increase the chances of miscarriage though most diseases affecting the endocrine system do not pose any threat.
There are lots of ways to treat miscarriages, even recurrent ones. It would be ideal to talk to the doctor about your options.