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!

Are you experiencing reduced libido along with intense dryness in your genitals? Loss of libido is a tough thing to cope with in women. In spite of having a great sex life, your vaginal area can become nonresponsive because of several reasons. You might not even know what is happening and the reasons which are causing the condition. These conditions are common in the menopause stage in women.

Reasons for decreased libido and vaginal dryness: 

1. Several changes occur in a woman s body during the menopause stage. The sex hormones, which include estrogen and progesterone start decreasing. This may lower your libido, cause vaginal dryness and affect your sex life to a great extent.

2. Testosterone is the sex hormone which turns you on or gets you into the mood for having sex. When the production of this hormone is insufficient, the urge for having sex gets affected and reaching an orgasm gets even harder.

3. The decrease in estrogen production causes several physical changes in a woman. The blood circulation to your sexual organs gets reduced, making you less sensitive to any kind of sexual stimulation. It also leads to vaginal dryness. The walls of the vagina also become thin due to which penetration may get painful.

Remedies for decreased libido

1. You should start practicing breathing exercises and do meditation for at least thirty minutes every day. This will enable you to eliminate stress, which is a primary trigger for decreased libido.

2. For balancing the estrogen levels, you should consume phytoestrogenic tea and supplements. Some important herbs which you should take include black cohosh, red clover and dong quai.

3. You should also consume aphrodisiac food items. Garlic is such a food item, which contains allicin and increases the blood flow to the vagina. Dark chocolate can also be taken.

Remedies for vaginal dryness

Several conventional vaginal lubricants may lead to irritation, infection and dryness of the vagina.

1. You should always use a natural lubricant, which is not associated with side effects and works effectively. Natural lubricants such as tea tree oil, coconut oil and vitamin E based oils provide effective vaginal lubrication. They also moisturize and repair the vagina.

2. You must keep fit and active. Regular cardio or yoga sessions will help with enhanced blood flow to your sexual organs, making you feel wet.

3. You should drink plenty of water and always stay hydrated in order to prevent dryness in the vagina.

Most importantly, it is a good idea to continue having sex. If you shy away and do not make any effort, the problem of decrease in libido will continue. Therefore, sex is the best way of encouraging your body. Proper communication with your partner is also necessary.

Decreased Libido and Vaginal Lubrication. What can you Do?

Lovemaking during pregnancy is less talked about because it is customary to distance pregnant ladies from intimacy. Many women even find it very uncomfortable to have sex during the pregnancy period as their body gets bigger.

However, there are other ways you and your partner can opt for to satisfy your needs like caressing, holding each other and kissing. There are some partners who feel sex during pregnancy is the best moment for sex, while there are others who are feared and have their own concerns.

Sex During Pregnancy - Pregnant Sex
Sex during pregnancy should be avoided. If at all done should be gentle, it should avoid pressing the abdomen. However, it is safe in the second trimester if the woman is comfortable. Yes, it is alright for partners to have sex from the second trimester onwards if the woman has had a healthy pregnancy.  This is because the thick mucus plug which seals the cervix in pregnant women safeguards the baby against any infection.

The strong muscles of the uterus as well as the amniotic sac, keep the little one safe in the womb. NO damage can be caused by the penis of your partner to the baby while having sex. Women can feel some movement of their baby after orgasm. Couples need not worry about the baby, as in no case it would provide discomfort to the baby. The chances of having a premature baby are reduced at times by having sex regularly.



Conditions to Avoid Sex During Pregnancy
The conditions in pregnancy when it is better to avoid sex mainly include times when any spotting or bleeding occurs during early pregnancy. In such a case, the Doctors advise not to have sex for at least 14 weeks.
Your doctor may even advise a pregnant woman not to have sex if she has a history of cervical illness, has had heavy bleeding, had a vaginal infection, and in case of the low lying placenta.
A pregnant woman experiencing frequent abdominal pain or cramps must also avoid sex during their pregnancy.
Sexual Behavior to Avoid During Pregnancy
There are 2 ways that are not safe and must be avoided while having sex during pregnancy. The first way is oral sex. Any pregnant woman must not allow their spouse to blow air into the vaginal region. Blowing air into the vagina can cause an air embolism, and this can be potentially serious for the mother as well as the baby.
Pregnant women should not have sex with partners who have an unknown sexual history as there are chances that he is infected with sexually transmitted diseases like HIV or Herpes. The diseases can be easily transmitted to the baby if you have sex with such a partner. It is better to avoid any complications and stay away from sex during the pregnancy period.
If you wish to discuss any specific problem, you can consult a doctor and ask a free question.

Conditions When to Stop Sex During Pregnancy

Clotting of blood during or after a pregnancy is fairly common these days. While the reasons for these are numerous, the driving reason behind this being that the mother is weak after such an ordeal and it is, therefore, likely to affect her health. In pregnant women, blood clots tend to form in the deep veins present in the legs or near the pelvic area. The condition is known as Deep Vein Thrombosis (DVT). One of the main concerns for people suffering from Deep Vein Thrombosis (DVT) is the occurrence of Pulmonary Embolism (PE), which is a life threating diseases and is caused when a DVT breaks and travels to the blood vessels connected to the lungs.

The symptoms of Deep Vein Thrombosis (DVT)
According to the data published on  Centre for Disease Control and Prevention  website, from a recent survey conducted it has been estimated that almost 900,000 people suffer from Deep Vein Thrombosis (DVT) every year in the United States i.e. 2 in every 1000 people suffer from this life-threatening disease. 

This disease although life threatening can be taken into account by proper medical care at the early stages and therefore patients are advised to look out for any or all of the following symptoms-

The patient is experiencing pain, swelling or tenderness in one of their legs, although both might have been affected.
You have noticed a change in skin colour, and it has taken a reddish shade.
There is a warm sensation in and around the area of the clot.
The veins on your legs are appearing larger than they should.
Although all of these are proven symptoms for Deep Vein Thrombosis (DVT), it is common to have discomfort from swelling legs during pregnancy and does not always mean that the patient has symptoms of Deep Vein Thrombosis (DVT). If you are having the slightest thought that it may be a case of Deep Vein Thrombosis (DVT), you should immediately contact your GP, midwife, or call your maternity unit.

Treatment for Deep Vein Thrombosis (DVT)
When a patient is suffering from Deep Vein Thrombosis (DVT) and she is pregnant, anticoagulants, which is a medicine that prevents clotting of blood, is administered to them. While not all anticoagulants are safe to use during pregnancy, quite a few are. It is highly advisable that a doctor or medical practitioner is consulted before taking any further step.

How to prevent Deep Vein Thrombosis (DVT)
Like all diseases around the world, Deep Vein Thrombosis (DVT) is too a preventable one if the certain Do s and Don ts are kept in mind. Below is a list of certain things to keep in mind, in order to prevent Deep Vein Thrombosis (DVT)-

Being active and moving around regularly, will keep the blood circulation normal.
Beware of your family history and consult your doctor with the same.
Look out for symptoms and contact your doctor at once if you see one.
Every disease is preventable and curable. It is on us, what we choose to do with it, succumb to it, or stand up and fight it. Look out for the above-mentioned points and you will be at a safe distance from the clutches of Deep Vein Thrombosis (DVT).

Blood Clotting During & Post Pregnancy - How It Can Be Prevented?

Most of us are affected by diseases, which spread through physical contact, but most of us do not consider it important to get them checked, due to which they turn into major ailments. Sexually transmitted diseases (stds) are infections, which are transmitted through any kind of sexual contact. The organism that causes the disease is transmitted from one person to the other during sex intercourse. Sometimes stds can be asymptomatic (no symptoms or signs)

Here are some stds that you should be informed about:

1. Gonorrhoea: genital infection caused by bacteria is called gonorrhoea, its symptoms include 

 Bloody vaginal discharge
 Painful urination
 Heavy period bleeding
 Anal itching

2. Chlamydia: bacterial infection in the genital tract is called chlamydia. Chlamydia is usually difficult to diagnose, its symptoms include

 Pain during urination
 Pain in lower abdomen
 Vaginal discharge
 Painful intercourse
 Bleeding between menstrual cycles

3. Syphilis: the bacterium treponema pallidum causes syphilis, its symptoms include

 Rashes
 Sores in the mouth, anus or vagina
 In later stages, it causes nerve and organ damage

4. Genital herpes: the herpes simplex virus (hsv) causes herpes. Signs and symptoms include-

 Small red bumps or ulcers in the anal, genital and other areas
 Itching or pain around the genital area, thighs and buttocks

5. Human papillomavirus (hpv) and genital warts: genital warts are caused by hpv. It infects the genital tract. Hpv has been linked to cervical cancer, its symptoms include

 Small swellings in the genital area
 Itching
 Bleeding during sex

6. Chancroid: chancroid is a bacterial infection. The bacterium haemophilus ducreyi causes chancroid, its symptoms include

 Development of red bumps on the skin folds covering the genitals
 Pain during urination
 Burning sensation during bowel movement

7. Ectoparasitic infections: ectoparasitic infections are caused by small parasitic bugs like mites or lice. The parasites usually affect the hair or skin. Scabies and crabs are common parasites that cause such infections. They both cause intense itching and visible rashes.

8. Human immunodeficiency virus (hiv) and acquired immunodeficiency syndrome (aids): the virus that causes aids is called hiv. It can spread through blood, vaginal fluids, semen and breast milk. Unprotected sex or sharing needles with an infected person is how the disease spreads. It includes symptoms, such as

 Slight fever
 Fatigue
 Muscle aches
 Weight loss.

Most Common STDs in Women

High blood pressure and sex

High blood pressure is a condition in which the pressure of the blood against the artery wall is high enough to cause health problems, including heart disease. No symptoms may be noticed in a person for years but the damage to the blood vessels and to your heart continues. High blood pressure can have an impact on your sex life. Although sexual activity does not lead to any possible threats to your health but high blood pressure can affect the pleasure you would have otherwise derived from sex.

In Men

High blood pressure leads to the wearing out of the lining of blood vessels and causes arteries to narrow and harden that decreases the blood flow. This results in decreased blood flow to the penis. In case of some men, this decreased blood flow makes it difficult for them to achieve and maintain an erection. This problem is called erectile dysfunction.

High blood pressure may also interfere with ejaculation and be a cause for low libido. The medications that are prescribed for treating high blood pressure may lead to this condition.

In Women

Just as in the case of men, high blood pressure results in the decreased flow of blood to the vagina in case of women. This may cause problems like low libido, vaginal dryness, or complexities in achieving orgasm. Sexual dysfunction in women results in stress, anxiety and even relationship issues.



High Blood Pressure and Sex

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