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!

The most devastating period for any pregnant women is a miscarriage. This normally happens because of genetic abnormality noticed in the fetus caused due to tripling of a chromosome. This is also called  spontaneous abortion  because the body rejects the random genetic abnormality. Apart from this, there are many other reasons for miscarriage namely blood clotting, deshaped uterus, uterine fibroids, unhealthy cervix and so on. Now, this could lead you to the next question - What can we do to prevent miscarriage?

Time to meet the gynecologist:
When there is tripling of chromosomes or genetic mismatch, the body actually rejects the fetus, thereby preventing birth of an unhealthy baby. But, if the miscarriage repeats several times, then you have to meet your gynecologist for further tests and appropriate medical intervention.

Symptoms of miscarriage:
In the normal course, when miscarriage occurs, the women would experience back pain or vaginal bleeding or blood in the vaginal mucus or cramping or abdominal pain. Ironically, sometimes the miscarriage may happen without any of these symptoms. It would get noticed only during routine scanning. However, in the normal course, the chance of a miscarriage is highest before the 12th week. But if miscarriage happens after the 12th week and before the 24th week, then it is called spontaneous abortion. Thereafter, it is known as a  still born  baby.

However, there are some steps that can help women prevent a miscarriage. These steps are briefly explained here.

Nicotine retards growth of fetus and it is for this reason the couple should shun smoking, months before they plan pregnancy. This change in lifestyle has remarkable effects in preventing miscarriage. Similarly, caffeine can also be the cause of miscarriage. Therefore, women should regulate their intake of coffee as per the advice given by the gynaecologist.
Women suffering from chronic ailments like lupus, problems with thyroid, epilepsy and such other ailments are prone to a miscarriage. Similarly, it is also advisable that women should get tested for STD/HIV because these ailments can cause a miscarriage. Women suffering from such ailments should be under constant medical care.
In addition to these, the women should take food rich in vitamins, proteins, Omega-3 and fibres. Further, they should also do physical exercises as per the instructions given by the gynaecologist. One should drink enough water so as to keep oneself sufficiently hydrated. Women must practice meditation, which helps in reducing stress.
The causes of a miscarriage are many; women should discuss about the issues relating to a miscarriage with their gynaecologist. This helps them take appropriate preventive steps against this unwanted situation.

Miscarriage - Can You Prevent it?

It's normal to be concerned with your fertility after early miscarriage. Many couples want to try to conceive again right away, while others need time to heal. Ultimately, though, fertility following a miscarriage is an issue of concern for most couples.

Once you are ready to start trying for a child again, there are a number of things you can do to increase your chances of having a successful pregnancy.

Rest and Recuperate- Many women want to hurry and start trying to get pregnant again right away after their miscarriage. This is a perfectly normal response, but may not be the best way to guarantee a healthy pregnancy. Give your body a chance to rest so your menstrual cycle can get back to normal. You also want to give yourself plenty of time for your mental balance to return so you are ready to take on the trials of trying to become pregnant. Be gentle and give yourself time to rest and focus on taking care of your physical and emotional needs until you are ready to try again.
Change Lifestyle- Eliminating unhealthy habits can help increase your chances of conceiving later. Eliminate drug or alcohol use and quit smoking before you start trying for pregnancy. Cutting down or eliminating caffeine can also help you conceive a healthy pregnancy.
Eliminate Stress- Eliminating stress can also make conceiving easier. Stress can reduce fertility levels, making it harder to get pregnant. Practicing meditation, yoga or taking time to relax after dealing with tough issues in your life can make it much easier to conceive.
Eat Healthy- Eating a healthy diet is also essential to having a healthy pregnancy. This can also help women manage the depression caused by their miscarriage. Getting a variety of vitamins and minerals and cutting down on saturated fats and processed foods can help you get pregnant and maintain a healthy pregnancy.
Take Fertility Drugs or Therapies- There are various fertility drugs and therapies on the market today. Your doctor will prescribe different medications based on your overall health and age.
Use an Ovulation Predictor- An ovulation predictor can help you map out your cycle. This will allow you to determine which days in your cycle will be the most likely for you to conceive. 
Support the Uterus and Liver- Performing a fertility cleanse after your period has stopped can help support the uterus and liver, promoting overall fertility health. Sometimes stagnant blood can get left behind after your period which can cause discomfort or health issues. Following a fertility diet to help rid your body of the excess blood and hormones in your system can help your conceive more easily.
Massage the Uterus- When you have stopped bleeding after your miscarriage, performing a uterus massage can help your body relax. This massage will help bring fresh blood to the area and soothe the body so you can relax. 
If you have been having trouble conceiving it may be time to talk to a fertility expert. Your doctor can perform fertility tests on you and your partner to determine if there are any underlying issues present. Then you can work together to determine if any additional medical treatment is necessary to help you get pregnant.

Ways to Increase Fertility after Miscarriage

Recurrent pregnancy loss is termed as the occurrence of three or more miscarriages. Recently, the American Society for Reproductive Medicine has altered the definition and limited the number of miscarriages to two. A pregnancy loss can only be termed so if the pregnancy is clinically recognized and is ends involuntarily before 20 weeks. The pregnancy loss must be identified by a registered doctor to term it as pregnancy loss.

What are the major causes of Recurrent Pregnancy Loss?
There could be a lot of reasons behind recurrent pregnancy loss. Most of the pregnancy failure happens from reasons such as abnormalities of the genes, chromosomes and other random events. It is estimated that close to 15 percent of the pregnancies end up in miscarriages. While 30-60 percent of the pregnancies expire within the first 12 weeks, fifty percent of the women are believed to be not aware of the pregnancy in the first place. The risk of miscarriage, however, is less than 50 percent.

An advanced maternity age is another crucial factor towards recurrent 2pregnancy loss. The risk of miscarriage dramatically increases among these women owing to their poor quality of egg, abnormalities in the chromosome etc. At a time, it has been observed that either the father or the mother might have irregularities in the gene leading to early miscarriage.

An abnormality in the uterus might also be a reason for a miscarriage. Poor blood supply and inflammation of the uterus are two of the topmost reason for miscarriages among many women. While some women born with a defective uterus, some develop uterus anomalies due to lifestyle and unhealthy life practices.

Last but not the least, a woman s immune system might also play a pivotal role towards a miscarriage. Certain hormonal irregularities, diabetes and thyroid diseases might lead to a miscarriage. Then there are the environmental factors such as stress, occupational factors, lifestyle practices etc that contributes towards a miscarriage.

What are the tests conducted?
To evaluate the exact reason for repeated miscarriages, a doctor performs a detailed physical and surgical examination. Some other areas where a doctor sneaks into include family history, genetic history etc. A karyotype test might also be prescribed in case a doctor feels the need of doing so. The uterus cavity and the uterus are closely monitored to understand any potential lack in the anatomy. This is followed by a list of imaging tests that a doctor might prescribe. These include MRI, X-ray, hysteroscopy etc.

What are the treatment options?
The treatment options are decided based on the finding of the tests. Sometimes plain medicines along with antibiotics can cure the condition, while sometimes surgery might be required to fix any potential threat within the uterus. In any case, the probability of future pregnancy after treatment goes as high as 77 percent.


Recurrent Pregnancy Loss - Things You Should Avoid!

Natural therapies are a great option to support your body and prepare it for pregnancy. As with any approach trying to decrease the chance of miscarriage, these steps will help to nourish and support the body, inviting a healthy pregnancy to occur.

Preparing ahead of time for your pregnancy is also important for decreasing the chance of a miscarriage, these steps must be practiced for at least 3 months before you become pregnant again. If you are currently experiencing a miscarriage contact your doctor or midwife right away.

Prepare for conception: The first step is to prepare your body with fertility cleansing. Fertility cleansing helps you to support the liver in cleansing the body of old toxins and excess hormones while encouraging the uterus to cleanse itself of  old  contents, increasing uterine circulation and tone.

Eat a nutrient dense fertility diet: The next step is to nourish and build up your body to be a healthy, baby friendly body. This can be done through eating a well balanced and nutritious diet. What you eat has a strong impact on:

The health of your eggs
Your hormonal balance
Creating a healthy placenta
Decreases chance of a miscarriage
Building nutrient storage for baby
Creating a healthy reproductive system
Build a healthy foundation: One of the major foundational steps to increase your chance of having a healthy pregnancy is to take some basic vitamins, minerals, and EFA s. There are specific vitamins and minerals that are necessary for a healthy reproductive system, hormonal balance, and ovulation. Essential fatty acids are also extremely important for miscarriage prevention.

Recurrent Miscarriage - How Can It Be Avoided?

For a mother, a miscarriage is the last thing she would want to hear. It can pin her down psychologically, leading to trauma and stress in unfathomable measures. To understand miscarriage better: it is a condition wherein there is a loss of pregnancy within the first 22 weeks of getting pregnant. The primary symptom of a miscarriage is bleeding from the vagina. So if you experience vaginal bleeding during this phase, then consult a doctor for further guidance.

Why do they occur?
There are many reasons as to why a miscarriage may occur and no study has been able to put a finger on any one specific cause. Having said that, miscarriages are mainly caused due to the presence of unusual chromosomes in the baby. Chromosomes are genetic material that directs the growth and development of a baby. Chromosomes present in either excess numbers or less can hinder the development of the baby. If the miscarriage occurs during the second trimester (14th to 26th week), then it can be accrued to a health anomaly in the mother. A miscarriage may also occur because of a weak cervix as a weak cervix will not be able to hold a pregnancy. This condition is called cervical insufficiency and occurs when the woman is in her second trimester.

Is it possible to prevent them?
In most cases, miscarriages cannot be prevented. For women who have suffered multiple miscarriages, multiple medications might be required to help with their subsequent pregnancies. Following a healthy lifestyle is recommended as it can minimize the risk of a miscarriage. One must abstain from smoking and substance abuse and limit consumption of alcohol in order to keep the body in optimal condition. It is advised to maintain optimal weight levels and eat a well-balanced diet.

Post miscarriage
A miscarriage is a very traumatic experience for a mother to be; it can be emotionally debilitating. That is the reason counseling can help in times such as these. Start planning for a baby only once the symptoms have subsided and you have also had a period post the miscarriage. It is important to make sure that you are physically and emotionally ready to have a baby. Remember, a miscarriage doesn t mean the end of the world. One can enjoy a fully healthy and a successful pregnancy even after a miscarriage.

Miscarriage - Why it Happens?

Don't wait any longer, manage your Miscarriage online with a Lybrate doctor today

Consult for Miscarriage - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES