If you lose a baby before 24 weeks of pregnancy, it is called a miscarriage. If this happens in the first 3 months of pregnancy, it is known as an early miscarriage. Unfortunately, early miscarriages are common, with 10 20 in 100 (10 20%) pregnancies ending this way. Late miscarriages, after 3 months of pregnancy but before 24 weeks, are less common: 1 2 in 100 (1 2%) pregnancies end in a late miscarriage. When a miscarriage happens three or more times in a row, it is called recurrent miscarriage. Recurrent miscarriage affects 1 in 100 (1%) couples trying to have a baby.

Why does recurrent miscarriage and late miscarriage happen?

Sometimes there is a reason found for recurrent and late miscarriage. In other cases, no underlying problem can be found. Most couples are likely to have a successful pregnancy in the future, particularly if test results are normal.

There are a number of factors that may play a part in causing recurrent and late miscarriage:

Age, the older you are, the greater your risk of having a miscarriage. If the woman is aged over 40, more than 1 in 2 pregnancies end in a miscarriage. Miscarriages may also be more common if the father is older.
Antiphospholipid syndrome (APS- a syndrome that makes your blood more likely to clot) is uncommon but is a cause of recurrent miscarriage and late miscarriage.
Thrombophilia (an inherited condition that means that your blood may be more likely to clot) may cause recurrent miscarriage and in particular late miscarriages.
Genetic factors, about 2 5 in 100 couples (2 5%) with recurrent miscarriage, one partner will have an abnormality on one of their chromosomes (the genetic structures within our cells that contain our DNA and the features we inherit from our parents). Although this may not affect the parent, it can sometimes cause a miscarriage
Weak cervix is known to be a cause of miscarriage from 14 to 23 weeks of pregnancy. This can be difficult to diagnose when you are not pregnant. It may be suspected if in a previous pregnancy your waters broke early, or if the neck of the womb opened without any pain.
Developmental problems of the baby may lead to a miscarriage but are unlikely to be the cause of recurrent miscarriage.
Infection that makes you very unwell can cause a miscarriage. Milder infections that affect the baby can also cause a miscarriage. The role of infections in recurrent miscarriage is unclear.
An abnormally shaped uterus may contributes to recurrent miscarriage or late miscarriages. However, minor variations do not appear to cause miscarriage.
Diabetes and thyroid problems can be factors in miscarriages. They do not cause recurrent miscarriage, as long as they are treated and kept under control.
It has been suggested that some women miscarry because their immune system does not respond to the baby in the usual way. This is known as an alloimmune reaction. There is no clear evidence to support this theory at present. Further research is needed.
Are there any other risk factors?

Being overweight increases the risk of miscarriage. Smoking and too much caffeine may also increase the risk. Excessive alcohol is known to be harmful to a developing baby and drinking five or more units a week may increase the risk of miscarriage.

The chance of a further miscarriage increases slightly with each miscarriage. Women with three miscarriages in a row have a 4 in 10 chance of having another one. This means that 6 out of 10 women (60%) in this situation will go on to have a baby next time. 

Why are investigations helpful?

Finding out whether there is a cause for your recurrent miscarriage or late miscarriage is important as your doctor will be able to give you an idea about your likelihood of having a successful pregnancy. In a small number of cases there may be treatment available to help you.

What investigations might be offered?

Blood tests:

For APS- APS is diagnosed if you test positive on two occasions 12 weeks apart, before you become pregnant again.
For thrombophilia- If you have had a late miscarriage you should be offered blood tests for certain inherited thrombophilias.
To check you and your partner s chromosomes for abnormalities. You may be offered this test if your baby has been shown to have abnormal chromosome
Tests for abnormalities in the baby You should be offered tests to check for abnormalities in your baby s chromosomes. This is not always possible but may help to determine your chance of miscarrying again. If you have had a late miscarriage you may also be offered a postmortem examination of your baby. This will not happen without your consent and you will have the opportunity to discuss this with your health team beforehand.

Tests for abnormalities in the shape of your uterus. You should be offered a pelvic ultrasound scan to check for any abnormalities in the shape of your uterus. If an abnormality is suspected, further investigations may include a hysteroscopy (a procedure to examine the uterus through a small telescope which is passed through the vagina and cervix) or a laparoscopy (a procedure in which a surgeon uses a fine telescope to look inside the abdomen and pelvis).

Tests for 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.




What are my treatment options?

Treatment for APS

If you have APS and have had recurrent miscarriage or a late miscarriage, treatment with low-dose aspirin tablets and heparin injections in pregnancy increases your chance of having a baby. Aspirin and heparin make your blood less likely to clot and are safe to take in pregnancy.

Having APS means you are at increased risk of complications during pregnancy such as pre-eclampsia, problems with your baby s growth and premature birth. You should be carefully monitored so that you can be offered treatment for any problems that arise.

Treatment for thrombophilia

If you have an inherited tendency to blood clotting (thrombophilia) and have had a miscarriage between 12 and 24 weeks of pregnancy, you should be offered treatment with heparin. At present there is not enough evidence to say whether heparin will reduce your chance of miscarriage if you have had early miscarriages (up to 12 weeks of pregnancy). However, you may be still offered the treatment to reduce the risk of a blood clot during pregnancy.

Your doctor will discuss what would be recommended in your particular case.

Referral for genetic counselling

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 counselling.

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 anaesthetic. 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.

Surgery to the uterus

If an abnormality is found in your uterus, you may be offered an operation to correct this.

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).

What if no cause is found?

Where there does not appear to be a cause for recurrent miscarriage or late miscarriage, there is currently no evidence that heparin and aspirin treatment reduces the chance of a further miscarriage. For that reason this treatment is not recommended in these circumstances.

What does this mean for us in the future?

You and your partner should be seen together by a specialist health professional. Your doctor will talk to you both about your particular situation and your likelihood of having a further miscarriage and a successful pregnancy. If a cause has been found, possible treatment options will be offered to you to improve your chance of a successful pregnancy.

For couples where no cause for recurrent miscarriage has been found, 75 in 100 (75%) will have a successful pregnancy with this care. It is worth remembering that the majority of couples will have a successful pregnancy the next time even after three miscarriages in a row.

Recurrent And Late Miscarriage - Tests & Treatment For Couples!

Most people will give you a blatant No. And they are quite right to do so. But if you have been a habitual offender who can't unwind without their drink, pregnancy is going to be a big problem. So does the rule stand in all cases? What if you drank when you didn't know you were pregnant yet? What if you had a light drink here and there, will it literally spell disaster? Let's find out.

Contradictory advice everywhere: Most doctors will advice you to stay away completely from alcohol as soon as that first positive emerges in your test. Others may give you a little leeway and let you have an occasional drink. There are friends who'll confess to have cheated during their pregnancy and snuck in a beer or two and say that their kids turned out just fine. There are other friends will scorn on you for even thinking such a thing. Same goes for your relatives. Like all things in pregnancy, random advice will just not work.

How much can you drink? Let's assume that you are confident nothing will happen and want to be adventurous and give it a cautious try. Danish researchers have some good news for you. Some studies have shown that low to moderate consumption of alcohol does not harm the baby. In fact, in 2012, Danish researchers released a highly publicized study that found no major problems in children below 5 years whose mothers had consumed 1- 8 alcoholic drinks a week during pregnancy.

Unfortunately, not all research is made equal. With pregnancy, each mother, each child and progression of each pregnancy is different. It really has to be on a case by case basis and nothing can be taken on face value. Most people will still advise you to completely go off alcohol as there is 'no safe' amount during pregnancy. Some women have a larger quantity of the enzyme that breaks down alcohol. If a woman with lower levels of this enzyme drinks alcohol, it is more likely to harm her unborn child as the alcohol will remain in her bloodstream longer.

How alcohol can affect your child?

A number of disorders that can affect your child when in the womb and even after because of alcohol consumption. These disorders are collectively called 'Fetal Alcohol Spectrum Disorder'. It is characterized by increased risk in miscarriage and stillbirth. It can also result in the baby having low birth weight and increase problems with learning, speech, attention span, language and hyperactivity. Alcohol consumption may also affect girl child and a baby boy differently. While both may turn out to have aggressive and delinquent behaviour, girls are more likely to develop mental health problems too.

If you are unable to give up on alcohol, you need to immediately get professional help to overcome your addiction. Also note that the term 'non-alcoholic' beverage is misleading as they can contain trace amounts of it. Consult a doctor today on which drinks are safe for you.

Alcohol in Pregnancy: Is it Safe?

When you are pregnant, your body is at a very delicate stage as you are carrying another individual inside you. While you are pregnant, there are many restrictions and regulations you must follow to ensure the birth of a healthy child. Bad habits such as smoking and consuming alcohol are strictly prohibited. It is also advised that you should not be in any kind of stress.

When it comes to travelling, it depends on the stage of your pregnancy. You should consult your doctor before travelling and know well about the restrictions that would be imposed, even if you are allowed to travel. The ideal time for you to travel during pregnancy is after the second trimester, when you will be less fatigued.

Here are some tips you should follow if you choose to travel when you are pregnant.
Travelling by car, train
1. You should always put your seatbelt on while travelling in a car when you are pregnant. Wear both the lap belt and the shoulder belt to keep yourself and your baby inside, safe and static.
2. The airbags should always be turned on for safety purpose.
3. Buses are narrow and should be avoided when you are pregnant. If you are availing a bus, avoid getting up when the bus is moving. In case you have to move, take the support of the railings.
4. When you are travelling by train, always hold on to the railings and seats while moving about in motion.
5. Avoid long hour journeys in cars or trains. The maximum travel duration should be not more than six hours, when you are carrying a child.
6. Make it a point to halt at points to take a walk. This would enhance your blood circulation.

Travelling by air, sea
1. This mode of travel is safer than any other travel modes for pregnant women.
2. Pregnant women can fly until eight months or nine months, after consulting a doctor.
3. Moving about in an airplane, which is flying is a bad idea for pregnant women and should be avoided.
4. Always choose an aisle seat while travelling by air. It will make moving convenient in case you need to visit the restroom.
5. Choose to travel on trustworthy, major airlines with a pressurized cabin and avoid small airplanes or private jets. Do not travel above a height of 7000 ft.
6. Travelling by sea should be strictly avoided as it causes motion sickness and pregnant women might have nausea.

Travel for pregnant women is restricted in many ways, and all the instructions should be followed.

Is It Safe for Me to Travel During Pregnancy?

Vaginal bleeding is something that most women experience between their periods when they are not due for a menstrual cycle. It is considered as an abnormal occurrence when you bleed before you are expecting your menstrual period, or after you are done with your monthly cycle. It is usually characterised by bouts of spotting where a thick brown reddish discharge may be experienced. Also, this kind of bleeding is considered abnormal if it occurs during pregnancy or menopause.

Here are a few causes of abnormal vaginal bleeding:
1.  Hormones: An imbalance in the hormones like the estrogen and progesterone can lead to abnormal vaginal bleeding. These are the hormones that help in regulation of the monthly menstrual cycles. An imbalance can occur due to side effects caused by birth control pills that may not suit the individual, a contraceptive patch, or even contraceptive implants and injections. Further, an intrauterine device may also be the cause for this kind of bleeding. The hormonal balance can also get affected due to internal ailments like a dysfunctional thyroid gland and ovaries.

2. Pregnancy and Delivery: Some amount of spotting is considered normal in the first trimester of one's pregnancy. Yet, severe bleeding and persistent spotting must be reported to the gynaecologist immediately. Women also bleed for a while after the delivery of the baby, in the postpartum period. This may also happen when an abortion takes place as the uterus may not have come back to its original size and due to remaining foetal tissues within. Complications during the pregnancy like an ectopic pregnancy or a miscarriage can also lead to such kind of bleeding. An ectopic pregnancy is one where the egg gets implanted in the fallopian tube instead of entering and implanting itself in the uterus.

3.  Fibroids: Uterine fibroids are usually considered as non-malignant and non-cancerous growths within the uterus. These are common in many women who have gone through childbirth. These fibroids can also cause some amount of bleeding and spotting.

4. Infections: When there is an infection in the reproductive organs like the ovaries and uterus of the patient, there may be some amount of bleeding. An infection in this area can also cause inflammation, which is one of the primary causes of abnormal bleeding. This can also occur due to a sexually transmitted disease or STD, as well as painful intercourse and sexual abuse which can lead to scarring as well.

5. Cancer: One of the least common causes includes cervical, ovarian and other forms of cancer. 
Stress and diabetes can also cause abnormal vaginal bleeding in rare cases. It is best to see a doctor as soon as such bleeding takes place.

Causes of Abnormal Vaginal Bleeding

What is menopause?
Menopause is that phase in the life of a woman when she can no longer reproduce. It involves the loss of fertility and the cessation of the menstrual cycle. The woman will stop bleeding every month and the ovaries stop producing eggs that can be fertilized. Menopause normally sets on after the age of 40 and bleeding may permanently stop by the age of 50.

Post menopausal bleeding
You are known to reach menopause when you have not been bleeding for 1 entire year. Even a small amount of spotting should not have taken place. Post-menopausal bleeding is when bleeding occurs after a year of attaining menopause. It can be a serious health disorder and requires medical attention without any further delay.

Reasons behind post menopausal bleeding

Polyps that are mostly non-cancerous, unwanted growths on the cervical canal, uterus or ovaries are known to cause post-menopausal bleeding.
Thinning of the endometrium that lines the uterus can cause unexpected bleeding. It can be due to the rapidly receding levels of estrogen in the blood. It is also known as endometrial atrophy.
Endometrial hyperplasia is a condition that leads to the thickening of the inner lining of uterus (endometrium). It also leads to the growth of abnormal and malignant cells.
Endometrial cancer
Other health conditions such as reaction to hormone therapy, infections of the blood or reproductive organs, certain medications and blood-thinning drugs
Cancer of the ovaries, uterus or cervix
How it can be treated?

For diagnosis, you can undergo blood tests, ultrasounds, sonography and biopsy.
Hysterectomy is done to remove the uterus and cervix can be conducted for a complete cure. It also removes the ovaries, fallopian tubes and other lymph nodes.
Chemotherapy and other radiation therapies may be done for those who are in an advanced stage of endometrial cancer.
Medications such hormone regulators must be taken to prevent complications.

Post Menopausal Bleeding - Is it Normal?

10 natural remedies to cure irregular periods

One common problem amongst a lot for women is irregular periods. While normally women have eleven to thirteen periods in a year, those suffering from irregular periods might have lesser than even six or seven. While this can be due to various problems, there exist some foods which can help cure this problem

1) ginger - often used to relieve menstrual pain, ginger is also used to correct irregular periods. You can include powdered ginger in your food or drink ginger tea.

2) cinnamon - one superfood which has a lot of health benefits is cinnamon. One can have cinnamon powder with tea or lemon juice to cure irregular periods.

3) aloe vera - it is responsible for regulating hormones in our bodies. Drinking aloe vera juice not only helps reduce weight but also regulates the periods.

4) turmeric - it is known to balance the hormones and stimulate flow of blood in the uterus. Drinking it with milk helps relieve spasm and regulate irregular periods.

5) papaya - raw papaya aids in increasing the flow of blood in the uterus and in uterine contractions, thus helping cure irregular periods.

6) sesame seeds - these help in producing and balancing hormones. Eating them also helps in regulating irregular pain.

7) jaggery - it is rich in minerals and iron, hence help cure irregular periods which can arise due to anemia.

8) grapes - grapes too contain iron and help curing irregular periods caused due to anaemia.

9) buttermilk - with calcium, potassium, proteins and vitamin b complex, buttermilk aids hormone secretion, thus helping cure irregular periods.

10) coriander - its juice is another food that helps cure irregular periods.


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10 Natural Remedies To Cure Irregular Periods

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