What is recurrent miscarriage?

If you have three or more miscarriages in a row, doctors call it recurrent miscarriage. If you have experienced recurrent miscarriage, your GP or midwife will refer you to a gynaecologist. Your gynaecologist will try to identify the reason for your losses.

Having miscarriage after miscarriage may leave you feeling utterly drained of hope. At times, it may be hard to keep trusting in the future. This experience affects every aspect of a woman s life from her mental and emotional health to her physical health and social well-being. 

If you can, try to draw comfort from the fact that most women who experience recurrent losses do go on to have a baby. This is especially the case if tests can find no reason for the losses. Six out of 10 women who have had three miscarriages will go on to have a baby in their next pregnancy.

Treatment of Recurrent Pregnancy Loss

Treatment for anatomic abnormalities of the uterus involves surgical restoration through removal of local lesions such as fibroids, scar tissue and endometrial polyps or timely insertion of a cervical cerclage (a stitch placed around the neck of the weakened cervix) or the excision of a uterine septum when indicated.

A thin endometrial lining has been shown to correlate with compromised pregnancy outcome. Often times this will be associated with reduced resistance to blood flow to the endometrium. Such decreased blood flow to the uterus can be improved through treatment with sildenafil (Viagra), Terbutaline and possibly aspirin.

Sildenafil (Viagra) Therapy Viagra has been used successfully to increase uterine blood flow. However, to be effective it must be administered starting as soon as the period stops up until the day of ovulation and it must be administered vaginally (not orally). Viagra in the form of vaginal suppositories given in the dosage of 25 mg four times a day has been shown to increase uterine blood flow as well as thickness of the uterine lining. To date, we have seen significant improvement of the thickness of the uterine lining in about 70% of women treated. Successful pregnancy resulted in 42% of women who responded to the Viagra. It should be remembered that most of these women had previously experienced repeated IVF failures.

Terbutaline this is a medication that relaxes the muscle in the uterine wall and so permits improved hormone delivery to the endometrium. The use of Terbutaline will often cause an increase in heart rate. It should not be prescribed to women who have irregular heart beats (arrhythmias), and women who have decreased cardiac reserve.

Aspirin this is an antiprostaglandin that improves blood flow to the endometrium. It is administered at a dosage of 81mg orally, daily from the beginning of the cycle until ovulation.

Selective Immunotherapy Using Intralipid, heparin, aspirin and corticosteroid

Many causes of pregnancy loss or failure can be treated with immunotherapy comprising combinations of aspirin and heparin and corticosteroids (dexamethasone or prednisone) and Intralipid (IL) to regulate increased NKa. Achievement of optimal success with Intralipid/corticosteroid therapy requires that the treatment be initiated well before ovulation takes place (about 7-14 days prior to anticipated implantation). Given the fact that only 10-15% of natural cycles (with or without the use of insemination and/or fertility drugs) will result in a pregnancy, it follows that repeated administration of Intralipid will be required in most cases before a pregnancy will occur. IVF achieves pregnancy rates that are often 2-3 times higher. This often makes IVF a treatment of choice in cases of immunologic recurrent pregnancy loss.

Role of IVF

Preimplantation genetic diagnosis (PGD) a procedure whereby the embryo can be tested for genetic or structural chromosomal abnormalities requires the use of IVF to select the best embryo(s) for transfer to the uterus. In cases of structural chromosomal (translocations) egg or sperm donation is often another option worth considering.

In those cases where due to intractable anatomical or alloimmune dysfunction IVF repeatedly is unsuccessful or is not an option, Gestational Surrogacy might represent the only recourse other than adoption.
If a couple with Recurrent Pregnancy Loss is open to all of the diagnostic and treatment options referred to above, a live birth rate of 70%   80% is ultimately achievable.

Recurrent Miscarriage - How to Deal With It?

Miscarriages are quite common these days. Couples who experience miscarriage have to go through an emotional trauma. They feel frustrated because of doubts and many unanswered questions along with the emotional trauma they face. While some women feel that they are a failure after experiencing a miscarriage, some others feel extremely guilty about it. Therefore, it is very important for couples to know about miscarriage. 

Here are the six most frequently asked questions about miscarriage that you must know:

How common is it for a miscarriage to happen?

This is definitely one of the most asked questions about miscarriage. According to most doctors, miscarriage is quite common. Unfortunately, one in four pregnancies can end in miscarriage. Therefore, everyone knows someone who has suffered a miscarriage.

What can be the symptoms of miscarriage?
This is the 2nd most common question asked about miscarriage. The symptoms of miscarriage vary from person to person. For most women, the symptoms noticed are bleeding and pain. As the pregnancy advances, more pain and more bleeding are noticed. The pains are similar to extremely bad menstrual cramps. However, doctors also agree that if a woman experiences some bleeding, it doesn t always imply that a miscarriage can happen.

What are the causes of miscarriage?
A woman s age is linked to miscarriage. If a woman is over 35, the risk of miscarriage rises. This is because cells do not divide properly as women age. The DNA of a man can also play a role in miscarriage.

How do doctors treat miscarriage?
About 75 % of miscarriages occur after the embryo gets embedded into the uterus. No treatment is required for this kind of miscarriage. Most miscarriages happen during the first 12 weeks of pregnancy. These miscarriages can be resolved through medication or surgery. The miscarriages that occur after the 12 weeks can be extremely traumatic for women.

What is the biggest misconception of miscarriage?
The most common misconception of miscarriage is that it can happen due to activities like exercise and sex.

What can be done to prevent a miscarriage?
People often ask this question to their doctors. Although there is no particular way to prevent a miscarriage, people should maintain a healthy lifestyle during pregnancy. Obesity, smoking and drug use can enhance the risk of miscarriage, and hence they should be avoided. 

Aforementioned are the six most asked questions about miscarriage. You should always talk to your doctor, if you face any complications or problems during pregnancy. It is important to clear your doubts about miscarriage. You should also try your best to maintain a healthy lifestyle.

Miscarriage - 6 Common Questions That Are Asked?

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?

The term miscarriage is used to denote spontaneous termination of pregnancy before a fetus develops. In other words, miscarriage is denoted as spontaneous abortion in medical terms.  Abortion is a condition in which fetus is expelled from the womb and this normally happens within the first 20 weeks of gestation. 

What are the causes of sudden miscarriage?
Causes of an abortion or miscarriage may be due to fetal or maternal complications. Some of the fetal factors include:

Unwanted pregnancy
Abnormal development of fetus, either due to abnormal chromosomes or teratogenic factors.
Immunological factors
Problems with implantation
Serious health diseases like kidney disease
What are the homeopathic treatments for abortion?
Homeopathic medication system is one of the most popular and widely accepted holistic medication approaches used all over the world. The choice of remedy for any disease is based on individualized symptoms and lifestyle habits using a holistic method. In such a way, a state of complete wellness can be achieved by eliminating all the signs and symptoms that the patient is suffering from. The main objective of homeopathy is not just to manage the adverse effects of abortion. 

Some of the homeopathic remedies that are beneficial in treating abortion or miscarriage are given below:

Aconite Nap: Helpful in treating anxiety, excitement or fear experienced before the procedure.
Apis Mel: Medication used during the 3rd month of pregnancy
Aletris Far: Treats conditions of typical abortion that is done due to anemia or weakness or other conditions affecting the mother
Arnica Montana: To manage abortion that is done after an accident to treat the mother
Baptisia: Used in treating abortion is done due to shock, fever or mental depression. Often used for women under the age of 21.
Sepia: Used when there is an abortion during fifth to seventh month of pregnancy.
Thuja: Used to treat women who have a history of gonorrhea.
Syphilinum: Used for treatment when there the abortion is done due to syphilis.

How Homeopathy Medicine Helps in Sudden Miscarriage ?

Miscarriage is the early loss of foetus within 20 weeks of pregnancy. It is also known as  spontaneous abortion . According to research, about 8-20% of the pregnancies end in miscarriage. Out of the total number of miscarriages, 80% of them end within 12 weeks of pregnancy.

Types of Miscarriages and their Symptoms 

Threatened Miscarriage   As the term suggests, in this condition the process of miscarriage might have begun. This is the initial stage of the process. In threatened miscarriage, there is slight bleeding accompanied by cramps and pain in the lower back, which is usually mild. The cervix (the lower part of the uterus) remains closed. 
Inevitable and Incomplete Miscarriage   In these conditions, there is bleeding along with an open cervix. When there is dilatation and thinning of the cervix, miscarriage is inevitable. In incomplete miscarriage, part of the tissue comes out and a part remains inside the uterus. In inevitable and incomplete abortions, the bleeding and cramps are more severe. 
Complete Miscarriage   Complete miscarriage is when the embryo has completely emptied from the uterus. The pain and bleeding reduce once the foetus is expelled. This can be confirmed through ultrasound. 
Missed Miscarriage   In Missed miscarriage, there is no sign of the life of the embryo and there is no expulsion of the embryo. It can be detected from the absence of heartbeat of the embryo found on ultrasound. 
Recurrent Miscarriage   It happens when there are two or three miscarriages one after the other. It affects about 1% of the pregnancies. 
Risk Factors 

Increased maternal age i.e., women above 35 years. 
Excess or insufficient chromosome in embryo. 
Placenta is the organ which links mother and the baby for blood supply. Problem in the development of placenta can cause miscarriage. 
Excessive smoking and drinking during pregnancy. 
Obese women have higher risk of miscarriage. 
Long-term health conditions like high blood sugar, high blood pressure, liver disease etc.
Infections like rubella, malaria etc. 
Weakened cervix, which is the result of previous injury or surgery, can also result in miscarriage. 
What are the symptoms of a miscarriage? 

Bleeding or spotting can be one of the symptoms of miscarriage. It should be kept in mind that not all pregnant women who suffer from spotting or bleeding, end in miscarriage. 
Lower backache starts before or right after bleeding, which can be persistent or you could have cramps which may be mild or sharp and can feel like more of pelvic pressure. 
Missed miscarriages are detected through ultrasound when the doctor finds that there is no heartbeat of the embryo or when the uterus is not growing. 
What are the treatment options in miscarriage? 

Medical   In most of the cases, there are no specific drugs to stop a miscarriage from occurring. In some cases, certain hormonal preparations help. There is no point in prescribing medicines for prevention of miscarriage if there is heavy bleeding. 
Surgery   Dilatation and evacuation (D&E) is a simple operation which is done under general/local anaesthesia. In this operation, the cervical canal is dilated and contents present in the uterus are evacuated. There is no cutting involved as it happens through the vagina. The process needs only five to ten minutes, but the patient has to stay in the hospital for about 3-4 hours. 
This process is opted when: 

There is heavy bleeding. 
The patient suffers from missed miscarriage. 
What can you do to prevent miscarriage? 

Nothing much can be done to prevent miscarriage in most of the cases. However, following supportive measures may help: 

There should not be overexertion during pregnancy. Moderate amount of physical activity is permissible. 
One should have a well-balanced diet. Studies have shown that a diet loaded with fruits and veggies helps in overall well-being during pregnancy. One should limit the consumption of caffeine. 
Avoid smoking, alcohol and certain drugs to prevent miscarriage. 
Avoid stress and anxiety. 
Report to Doctor (preferably Obstetrician) as soon as any symptom related to miscarriage appears.

Miscarriage - Symptoms, Treatment and Prevention

Do you know about the various signs and symptoms that indicate a miscarriage? Miscarriage refers to pregnancy, which ends on its own, within 20 weeks of gestation. Miscarriage is a matter of great loss and grief for pregnant women. It accounts for being the most common form of pregnancy loss. According to studies, almost 10% to 25% of pregnancies result in a miscarriage. Chemical pregnancies are likely to be responsible for almost 50% to 70% of miscarriages.

Causes of miscarriage

The causes of miscarriage vary from one woman to another and in many cases the exact cause is not identified.
During the first trimester of pregnancy, chromosomal abnormality is the most common cause of miscarriage. It signifies some problem with your baby s chromosomes. Most cases of chromosomal abnormalities occur because of damaged eggs and sperm cells.
A certain problem which appears after the zygote goes through divisional procedures may also be responsible for a miscarriage.
Other causes for miscarriage include the following:

Hormonal imbalance, maternal health complications, and infections
Several habits such as smoking, malnutrition, excessive caffeine consumption, drug abuse, and exposure to toxic substances
Maternal age
Maternal trauma
When implantation of the egg in the uterine lining occurs improperly
Warning signs of miscarriage
There are several warning signs of miscarriage. The most important of them are as follows:

Back pain, which can vary from being mild to fatal. This pain can be even worse than menstrual cramps.
Loss of weight
Discharge of mucus that is whitish pink in color
True contractions are likely, in which pain occurs after every 5 to 20 minutes.
Bright red or brown bleeding with or without the presence of cramps may indicate a miscarriage.
Passage of tissue with a cloth material from your vagina.
Sudden reduction in the signs and symptoms of pregnancy
Chances of miscarriage
There are certain factors, which indicate whether you are likely to have a miscarriage. They are as follows:

Increase in your maternal age increases the chances of a miscarriage.
Women who are in between the age of 35 to 45 are at a higher chance of miscarriages than women who are relatively young. In women above the age of 45, the chances of miscarriage are maximized.
A woman having a miscarriage in the past has more chances of having another miscarriage.
In case you experience some or any one of these symptoms, it is important for you to seek professional health care as you need to evaluate whether you are having a miscarriage or not.


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