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!

Diabetes is one of the most common problems that are caused by obesity, unhealthy and inactive lifestyle. It is a metabolic disorder in which the body is unable to store and use energy from food. Being physically inactive and eating unhealthy food are primary causes of diabetes. It is a long term condition, which causes high or unstable blood sugar levels in the body.

When a patient suffers from low blood sugar it is called hypoglycemia and if the blood sugar levels are too high, it is called hyperglycemia. Both are extremely harmful for a patient.

Type 1 and type 2 and gestational diabetes:

Type 1

In type 1 diabetes, the body does not produce insulin. The condition has no known cure and is usually hereditary in nature. Approximately 10% of those suffering from diabetes have type 1 diabetes. Patients with type 1 diabetes have to take regular medication, including insulin injections as well as take care of their diet.

Type 2

Type 2 diabetes happens when the body does not produce enough insulin for its proper functioning. 90% of all diabetic people suffer from type 2 diabetes. It is usually caused by poor lifestyle choices, like physical inactivity and unhealthy food habits. The disease lasts a lifetime and is usually progressive in nature, but can be managed by taking regular medication, choosing an active lifestyle and maintaining proper body weight.

Gestational diabetes

Diabetes during pregnancy is known as gestational diabetes. This has to be managed by taking medication or in extreme cases insulin shots. If undetected or untreated, gestational diabetes increases complications during childbirth, and causes unusual weight gain in the baby. However, gestational diabetes usually ends after the baby is born and women can go back to their normal lifestyle and eating habits post delivery.

Symptoms of diabetes

 Frequent urination
 Extreme hunger or thirst
 Weight loss
 Problems with vision
 Tingling or numbness of the extremities.
 Unexplained fatigue
 Dry skin
 Cuts or sores that heal slowly
 High number of infections

Who is at greatest risk for developing diabetes?

People who:

 Are 45 or over
 Are overweight
 Are habitually physically inactive
 Have previously been identified as having ifg (impaired fasting glucose) or igt (impaired glucose tolerance)
 Have a family history of diabetes
 Are members of certain ethnic groups (including asian american, african american, hispanic american, and native american)
 Have had gestational diabetes or have given birth to a child weighing more than 9 pounds
 Have elevated blood pressure
 Have an hdl cholesterol level (the good cholesterol) below 35 mg/dl and/or a triglyceride level above 250 mg/dl
 Have polycystic ovary syndrome
 Have a history of vascular disease

What is pre-diabetes?

Pre-diabetes is a condition of elevated blood glucose level that has not yet reached a diabetic level. Along with insulin resistance, pre-diabetes causes no symptoms. An individual may be pre-diabetic for years without knowing it. Pre-diabetes increases your risk of developing type 2 diabetes and heart disease. Weight loss and exercise may halt the onset of diabetes from pre-diabetes by returning blood glucose levels to a normal range.

Diabetes: At A Glance

Let's start with an interesting fact: all types of tea, be it green or black, comes from the same plant, Camellia sinensis. The difference only lies in processing and oxidation. So how can one be better than the other you ask? Let's find out.

1. Fluoride content

When it comes to fluoride content both green and black teas score high, while milk tea sadly loses out. Green and black teas are good for your teeth and bones, although black tea has higher fluoride content (0.2-0.5mg as compared to 0.3-0.4mg in green tea). It is best to have your black tea with tap water as it increases the fluoride content up to 0.9mg.

2. Antioxidant content

Yet again green tea and black both have high antioxidant content that helps in preventing cancer, but green is the clear winner over. Milk tea loses again as the milk in it effects the absorption of these antioxidants by your body. Green tea is enriched with a particular type of catechin (flavonoid) called EGCG, which regulates gene activity in cancer cells, and may even prevent cancer growth.

3. Caffeine Content

Both black and green teas have different amounts of caffeine in them. Green tea has lesser caffeine content than black tea- 9-50mg/cup in comparison to 42-17mg/cup. So if you want to have an energetic morning then black tea is the one for you, but if you want to relax your blood vessels and just enjoy a soothing drink, choose green tea. Milk tea, unfortunately, does not have a calming or an energising effect.

Benefits for your heart:

Black tea is probably a healthier option if you want to derive cardiovascular benefits from your daily cuppa. While green tea has abundant EGCG which creates a lining along your blood vessels to reduce stress, black tea offers more benefits. Black tea can improve the function of your blood vessels if you suffer from coronary artery disease. Apart from that, both can lower the levels of harmful cholesterol. There's no evidence that supports that milk tea can be beneficial for your heart.

So, in the end, it's your call to choose black or green tea, whichever works best for you. Try avoiding milk tea as the milk steals away the essential health benefits of tea. Just remember to have no more than 10 cups of green tea a day, and no more than 4 cups of black.

Related Content: Try Auric skin radiance health drinks as an alternative for tea or coffee for glowing skin.

Milk Tea Vs Black Tea Vs Green Tea - Is Your Choice the Best?

Sit at the dinner table, and you'd find yourself invariably extending your hand to the glass of water on the side of your plate. While you may think it's absolutely necessary to have a glass of water during your meals, the truth is this habit of yours might be damaging your health. Read on to find out how.

1. It dilutes your gastric juices -
When the digestive acids (acids responsible for the digestion and breakdown of food as well as for killing infectious agents ingested with food) present in your stomach are diluted with water, they bring about a slowdown in the functioning of your entire digestive system. This slowdown results in food remaining lodged in your stomach for a longer period than normal, thereby causing indigestion.

Additionally, the reaction caused by the dilution of water and stomach acids can give rise to cramps in your tummy.

2. It reduces the saliva in your mouth -
The same thing that happens to the acids in your stomach, happens to your saliva as well. Water dilutes the saliva, which stops the breakdown of food in your mouth. Also, your saliva is responsible for stimulating your stomach to release digestive enzymes and prepare itself for the process of digestion. By drinking water with your meals, such signals sent by your saliva to your stomach become much weaker. All these together can make digestion very difficult.

3. It causes acidity -
Studies show that drinking water with your meals not only leads to the dilution of digestive enzymes, but also brings about a reduction in the secretion of digestive enzymes. This causes the undigested food in your stomach to leak into the lower part of your oesophagus (food pipe), causing acidity and heart burn. 

4. It increases insulin production -
Sipping on water in the middle of lunch (or any other meal for that matter) causes a spike in your insulin levels just as glycaemic foods (foods with high starch or sugar content such as honey, potatoes, white bread, rice to name a few) would. When your body is unable to digest food properly, it usually tends to convert the glucose filled part of that food into fat and stores it, reason why your blood sugar levels see an upsurge.

5. It adds to your weight -
Since drinking water causes an increase in insulin levels in your body (as the food you eat is converted to fat), it can result in the piling of extra weight on your body. This is because a weak digestive system is one of the major causes behind obesity.

Try having your meals with less salt and drink water 30 minutes before each meal to control your thirst when you're eating. This can help you in controlling the negative effects that drinking water with your meals can have on your health.

Make a wise choice and stay healthy. Feel free to ask me more questions you might have.

Watch What Happens When You Drink Water Along With Your Food. It'll Leave You Thinking!

Sex, which gives pleasure to most, can be painful for some. Many women, mostly in their menopausal or post-menopausal phase find intercourse and penetration extremely painful. Menopause results in hormonal imbalance, with a significant drop in the estrogen level. The reduced estrogen level results in Vulvovaginal Atrophy (dryness of the vagina and thinning and weakening of the vaginal tissues). In such cases, women experience irritation, Vaginismus (vaginal tightness) and soreness after sex.
 
One can also experience a burning sensation during urination. There may be inflammation of the vaginal tissues. If untreated, the inflammation can cause infection and other complications. "Dyspareunia" or pain during intercourse is very common in postmenopausal women. The pain experienced during sex can be due to "Vulvodynia" as well. Vulvodynia is a condition whereby a women experiences chronic pain in the external genitals or vulva. A number of other factors can also contribute to the pain during sex. A thorough and detailed investigation is thus very important.
 
Treatment
Many women find it extremely embarrassing to discuss menopausal problems with their partners and doctors. The key to effective treatment lies in timely diagnosis and medication. There is nothing to be embarrassed about. The postmenopausal changes can vary from person to person. Thus it is very important to discuss every minute detail with your physician.

Many options are available to make intercourse a less painful experience:

Keep dryness at bay: In most cases, painful intercourse results from dryness of the vagina. Use of a lubricant can ease the pain to a great extend. A water-based lubricant is highly recommendable. Regular use of vaginal moisturizers is also effective to deal with vaginal dryness.

Vaginal care and hygiene: It is very important to keep the vagina clean. Avoid using soaps, bath oils and shower gels. They do more harm than good to the vagina. It is advisable to wash the vagina with warm to lukewarm water. Undergarments should be changed twice daily.

More is good: Having sex at regular intervals is a healthy practice. It not only enhances and improves the blood flow, but also helps to overcome vaginal dryness.

The Pelvic Floor Therapy: It is immensely beneficial. In this therapy, a gentle pressure is exerted in the pelvic region to relax the stiffened and tightened muscles. One can also massage the area to relax the muscles.

Squat: It is a very effective exercise to strengthen the buttocks and hip muscles. Exercises to strengthen the pelvic floor muscles are also very helpful.
Other therapies: One can also opt for Local Estrogen therapy and Systematic Estrogen Therapy.

Menopause should not affect your conjugal and sexual life. Visit here to know more and forget painful intercourse forever.

Pain With Intercourse In The Postmenopausal Woman

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.

Apply fertility or abdominal massage: Another important element of promoting a healthy conception is to increase circulation to the uterus. Through applying a simple massage method called self fertility massage you are able to increase the circulation to the uterus, clear adhesions and congestion.

4 Steps to Decrease the Chance of Recurrent Miscarriage

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

Consult for Robotic Gynecologist - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES