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Miscarriage Tips

Recurrent Miscarriage - How to Deal With It?

MBBS
IVF Specialist, Raipur
Recurrent Miscarriage - How to Deal With It?

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 level of Natural Killer Cell Activation (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.

6363 people found this helpful

Recurrent Pregnancy Loss - What Can Constitute It?

DNB - Obstetrics & Gynecology, MBBS
Gynaecologist, Pune
Recurrent Pregnancy Loss - What Can Constitute It?

Recurrent miscarriage is a condition when there have been three or more successive pregnancy losses. It is different from infertility as infertility is the inability to conceive. For many cases, the cause of a recurrent miscarriage has not always been found. A number of factors can cause recurrent miscarriages of which some are treatable. It may not always be possible to identify a cause for recurrent miscarriage in a couple even after extensive research and treatment procedures. Some of the common causes of recurrent miscarriage are described below:

1. Chromosomal abnormalities
Incompatible chromosomes can result in pregnancy losses. When an egg and a sperm meet, of which one of them is faulty, they can't line up properly resulting in chromosomal abnormality. Such conditions lead to miscarriages.

2. Uterine abnormalities or Incompetent cervixes
Miscarriages occur if the uterus is abnormally shaped since the embryo is not properly implanted or even if it gets implanted, it may not get sufficient nourishment to survive. If the woman has a weak cervix, it cannot hold the developing embryo, leading to miscarriage.

3. Immunologic disorders
Under rare cases, the embryo itself is not accepted by the body. Antiphospholipid antibodies are antibodies which attack self-tissues such as embryos and prevent them from building up. This leads to miscarriages.

4. Untreated thyroid problems
Conditions such as thyroid or uncontrolled diabetes result in uterine conditions which make it tough for the embryos to survive.

5. Polycystic ovary syndrome
Women with polycystic ovary syndrome tend to have high levels of male hormones which result in irregular menstruation and ovulation. This can prevent the lining of the endometrium from maturing that is required for holding the embryo.

6. Bacterial infections
There may be a presence of a number of micro-organisms inside the reproductive tract that may be harmless for the person. But there may be certain bacteria lined up in the reproductive tract which can prevent the development of an embryo, thus leading to miscarriages.

7. Lifestyle
Smoking and drinking are harmful lifestyle habits which may increase the chances of miscarriages to a great extent. It is always advised to avoid smoking or drinking when you wish to conceive. Other lifestyle conditions, such as working in certain environments like hospital environments, farms, laboratories, etc, may lead to miscarriages; however, the exact reason has not been identified yet.
 

8614 people found this helpful

Recurrent Miscarriage - How To Avert It?

MBBS, MD - Obstetrtics & Gynaecology, DGO - Obstetrtics & Gynaecology, FCPS - Dermatology, Venereology & Leprosy
Gynaecologist, Navi Mumbai
Recurrent Miscarriage - How To Avert It?

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 practised 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:

  1. The health of your eggs
  2. Your hormonal balance
  3. Creating a healthy placenta
  4. Decreases chance of a miscarriage
  5. Building nutrient storage for baby
  6. 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.

1205 people found this helpful

Miscarriage - How To Overcome It?

DGO, MBBS, FOGSI
Gynaecologist, Ahmedabad
Miscarriage - How To Overcome It?

Once the reality of the positive pregnancy test sets in, dreaming about the yet-to-arrive begins. Curiosity about gender, options for names, ways to manage, shopping ideas, etc., begin to get discussed.  And then totally out of the blue, the news comes that there is a miscarriage. This is one of the most depressing phases. It is very important for the family to be around and support each other. While the entire family is upset and hurt over the news, the mother needs most care as there is just not emotional but a huge physical component also to the episode. On the other hand, remember that miscarriages are extremely common, and is no indication of a fertility issue.

The first step would be to diagnose and confirm the miscarriage.  After that, depending on whether it was complete or incomplete, some medical intervention might be required.  In most cases, medications like misoprostol are given to expel the uterine contents.  These help by clearing out the contents in about a couple of days' time. In some cases, a D&C might be required if your doctor suspects that medication will not suffice. This also helps identify if there is an issue in the uterus that could have caused the miscarriage.

While the above take care of the physical part, the emotional component also requires cautious management. Needless to say, this is trickier than the earlier one.

Mourn to your heart's content - When you have nursed a life within you and have lost it, it is very normal to cry for its loss. There would be a mix of emotions - shock, denial, confusion, anger, grief, depression, etc. Take some solace from that fact that this is nature's way of removing unhealthy fetuses.

Get someone to talk to - Need not to be your husband, but anybody whom you can talk to without having to watchwords. A sibling, a good friend, a close relative - your choice.  Make sure you don't pick ones who will judge and sympathize with you. More than sympathy, you need someone understanding and knowledgeable.

Socialize more - As you would have kept to yourself post your positive test, use this time to socialize more and meet friends whom you have not regularly been in touch with. Close family members, your children (if you already have), society groups, movie groups, etc., help to a great extent.

Formal medical counselling: If you are not able to cope with your regular circle of family and friends, try seeking professional advice from counselling.

Spirituality - Whether you believe in temple or churches, spend some time there.  Involve in some religious activity if you would like, this helps very often.

As much as it is painful and traumatic, it is not very uncommon or unnatural.  Get back on your feet, the sooner you do, the better. 

1344 people found this helpful

Laparoscopic Abdominal Cerclage For Mid Trimester Miscarriage!

MBBS, MD - Obstetrtics & Gynaecology, Fellowship in Laparoscopy, DNB (Obstetrics and Gynecology)
Gynaecologist, Chandigarh
Laparoscopic Abdominal Cerclage For Mid Trimester Miscarriage!

Laparoscopic abdominal cerclage- placing tape around the cervix (mouth of the uterus) to prevent miscarriage in a patient with proven cervical incompetence (loose cervix) and failed vaginal cerclage leading to second-trimester miscarriage. The tape is placed at the level of the internal os, much higher in cervix compared to vaginal cerclage, hence giving a better success rate, more than 90 percent successful pregnancy. Laparoscopy cerclage is very fast surgery, bloodless, painless and patient is discharged on the same day. Total time taken for surgery is approx 20mins.

Know How To Deal With Vaginal Bleeding During Pregnancy!

MBBS, MS - Obstetrics and Gynaecology
Gynaecologist, Sri Ganganagar
Know How To Deal With Vaginal Bleeding During Pregnancy!

Bleeding from the vagina during the pregnancy period in women can be quite a traumatic experience. Bleeding during pregnancy occurs due to several reasons. While some of these reasons can be ignored and are considered natural, the others might be of concern. 

Vaginal bleeding accompanied by spotting is common in women within twelve weeks of pregnancy. The cervix getting infected might also be a cause of the bleeding. This pauses by itself after a certain period. However, bleeding from the vaginal area during pregnancy phase may also lead to something as severe as miscarriage or an early born infant. 

Once u get bleeding after getting pregnant consult ur doctor as early as possible, it's the doctor who will guide u whether to wait or some action has to be taken.

For proper assessment and control of the bleeding, you should undertake the following actions:

1. Keep a track on the bleeding.
You must have an idea about the amount of blood loss you have had. It will make your doctor's work much easier to understand the intensity and the root of the problem. He will also be able to present you with a control plan. You have to keep a pad in your underwear and let it get soaked. Keep a track on how many pads get used by in a span of 24 hours. Notice the other features of the bleeding as well; whether there is pain or not and the intensity of the bleeding. Keep a constant check on the color and shade of the blood, and mention the presence of blood clots if any to your doctor.

2. Take sufficient amount of rest.
Untroubled, peaceful bed rest for long duration is the primary treatment to prevent pregnancy bleeding. During the early days of bleeding, total bed rest is recommended by all doctors. In case the bleeding cannot be checked regardless of sufficient rest, you should call the doctor.

3. Abstain from any form of heavy physical work.
Any kind of physical labor which produces strain in the body such as running, jogging, jumping, cycling or going up and down a staircase quite often should be strictly prohibited during pregnancy. Undertaking these activities causes the uterus to jerk, and may lead to the breakage of delicate blood vessels within the placenta. On the off chance that the bleeding is less, activities of this kind should be still strictly avoided. Even after the bleeding stops, keep away from any strain for two more weeks.

4. Do not indulge in sexual intercourse.
Sexual intercourse during pregnancy can enhance vaginal bleeding to a great extent. For women facing bleeding during this phase, it is advised to keep away from having sex until your doctor advises.

Pregnancy bleeding is a serious issue, and it must not be neglected in the slightest of extent.

1104 people found this helpful

Exercise & Pregnancy - Can We Mix Both?

MBBS, MD - Obstetrics & Gynaecology, Fellowship of Gynaecology Oncology, Fellowship in Laparoscopy
Gynaecologist, Raipur
Exercise & Pregnancy - Can We Mix Both?

Contrary to what some people may believe, exercise during pregnancy does not raise the risks of miscarriage or low birth weight or an early delivery. On the contrary, it offers a host of benefits to both the mother and the child. However, this doesn't mean that there are no risks of a workout during pregnancy whatsoever.

Women who have been active before pregnancy may continue with the exercises. But, those who are new to exercise must get advice on the exercise regimen from an expert. Here is an account of the benefits and the risks associated-

Benefits of exercise on the mother’s emotional health
Various studies have shown that women who keep themselves physically fit during pregnancy are generally more relaxed, and thus they can cope better with the psychological and emotional strains of pregnancy.

Women, who work out throughout pregnancy develop a better sense of wellbeing owing to a wide array of positive effects from exercise such as controlling weight and maintaining body image and self-esteem. It also helps improve sleep. Further, it is believed that the positive effects stay even after delivery, which may reduce the incidence of postnatal depression.

It is a proven fact that women who exercise during pregnancy experience an increased muscular and cardiovascular strength and fitness. It also improves posture owing to the increase in abdominal and upper body strength. Exercising during pregnancy improves blood circulation, which, in turn, can prevent varicose veins as well as deep vein thrombosis. It also helps reduce instances of constipation and swelling. Furthermore, the expectant mothers experience less pain during labor along with reduced medical interventions. It is also proven that the mothers, who work out regularly, give birth to an emotionally and physically healthy baby.

Risks of exercising during pregnancy
Though exercise is proven to be a safe means of mitigating various problems, it can bring about some risks and complications as well.

The hormones which are stimulated during pregnancy can induce premature contractions. Also, it causes an increase in glucose consumption for helping the fatigued muscles to cope up. It may affect the glucose level of the fetus as well. Overheating while exercising can disrupt the maternal thermoregulation to a great extent. Therefore, one should refrain from strenuous workouts or work out in high temperatures.

A few specific risks-
Exercise during pregnancy is not advisable when you have medical conditions like asthma, Type I diabetes or heart disease. Also, women with obstetric conditions such as bleeding or spotting, and weak cervix must refrain from exercising.

It is necessary to take an opinion from your gynecologist before you start with your exercise plan. Particularly, when you wish to do aerobic exercises, it is quite necessary to consult your doctor as the exercises may not suit you under several conditions.

Thus, staying active with an exercise plan is beneficial, but with necessary care and guidance, of course.
 

1259 people found this helpful

Cautious Signs You Should Never Ignore During Pregnancy!

DNB - Obstetrics & Gynecology, MBBS
Gynaecologist, Pune
Cautious Signs You Should Never Ignore During Pregnancy!

If you want to have a safe pregnancy by curtailing all sorts of complications, then you have to promptly respond to warning bells. There are certain warning symptoms that should not be neglected at all as that might put your pregnancy in danger. 

Bleeding

This kind of situation cannot be ignored as that often leads to serious issues like placental abruption or miscarriage. In this case, you are definitely in need of the assistance of any expert midwife.

Swollen face or hands 

Slightly swollen face or hands in pregnancy are normal, but if you observe excessive puffiness, especially on your feet and ankles, then it is a warning sign as it might lead to toxaemia or PIH. Therefore, consulting a doctor is very much needed in this regard.

Abdominal pain

Round-ligament pain is quite normal, and you do not have to worry about the same. But if the pain is accompanied by bleeding, then the danger of miscarriage might come into being, and thus you should be very much alert about the same.

Blurry vision

Both blurry vision and dizziness are the commonest pregnancy symptoms. But if they get increased suddenly, visit your doctor. 

Itching 

Itching is common during pregnancy mostly due to stretching of the skin. Your skin also becomes dry. But if it continues for long, then you should check the same with your doctor for avoiding liver disorder. 

Fever

Exposure to flu and cold viruses increases during pregnancy, as a result of which fever occurs. But if the fever lasts for more than 48 hours, then viral conditions can be expected, which are pretty dangerous. 

Unwanted back-pain

Normal pain in pregnancy is alright, but excessive pain might indicate bladder or kidney infections, preterm labour, miscarriage or cyst. All these conditions should be essentially avoided to ensure a healthy 
pregnancy. 

Gushing of fluid

If you are not in labour, but are feeling wet constantly, then it is better to see a doctor. There might be a great possibility of breaking of water, and this is quite dangerous in the advanced stage of pregnancy. 

Less movement of baby 

Experiencing baby kicking is quite natural during pregnancy, and if stops suddenly, then there is something wrong. Kicking patterns should be followed and then only you will be able to realize whether the baby is normal or not. 

If you are facing any of the above symptoms, then immediately visit your doctor.
 

7880 people found this helpful

Recurrent Miscarriage - What Can Lead To It?

MBBS, MD - Obstetrtics & Gynaecology, Fellowship in Laparoscopy, DNB (Obstetrics and Gynecology)
Gynaecologist, Chandigarh
Recurrent Miscarriage - What Can Lead To It?

Recurrent miscarriage is a condition when there have been three or more successive pregnancy losses. It is different from infertility as, infertility is the inability to conceive. For many cases, the cause of a recurrent miscarriage has not always been found. A number of factors can cause recurrent miscarriages of which some are treatable. It may not always be possible to identify a cause for recurrent miscarriage in a couple even after extensive research and treatment procedures. Some of the common causes of recurrent miscarriage are described below:

1. Chromosomal abnormalities
Incompatible chromosomes can result in pregnancy losses. When an egg and a sperm meet, of which one of them is faulty, they can't line up properly resulting in chromosomal abnormality. Such conditions lead to miscarriages.

2. Uterine abnormalities or Incompetent cervixes
Miscarriages occur if the uterus is abnormally shaped since the embryo is not properly implanted or even if it gets implanted, it may not get sufficient nourishment to survive. If the woman has a weak cervix, it cannot hold the developing embryo, leading to miscarriage.

3. Immunologic disorders
Under rare cases, the embryo itself is not accepted by the body. Antiphospholipid antibodies are antibodies which attack self-tissues such as embryos and prevent them from building up. This leads to miscarriages.

4. Untreated thyroid problems
Conditions such as thyroid or uncontrolled diabetes result in uterine conditions which make it tough for the embryos to survive.

5. Polycystic ovary syndrome
Women with polycystic ovary syndrome tend to have high levels of male hormones which result in irregular menstruation and ovulation. This can prevent the lining of the endometrium from maturing that is required for holding the embryo.

6. Bacterial infections
There may be a presence of a number of micro-organisms inside the reproductive tract that may be harmless for the person. But there may be certain bacteria lined up in the reproductive tract which can prevent the development of an embryo, thus leading to miscarriages.

7. Lifestyle
Smoking and drinking are harmful lifestyle habits which may increase the chances of miscarriages to a great extent. It is always advised to avoid smoking or drinking when you wish to conceive. Other lifestyle conditions, such as working in certain environments like hospital environments, farms, laboratories, etc, may lead to miscarriages; however, the exact reason has not been identified yet.
 

2044 people found this helpful

Is Exercising Vital During The Phase Of Pregnancy?

MS - Obstetrics and Gynaecology, DNB (Obstetrics and Gynecology), DMAS, MBBS
Gynaecologist, Lucknow
Is Exercising Vital During The Phase Of Pregnancy?

Contrary to what some people may believe, exercise during pregnancy does not raise the risks of miscarriage or low birth weight or early delivery. On the contrary, it offers a host of benefits to both the mother and the child. However, this doesn't mean that there are no risks of a workout during pregnancy whatsoever.

Women who have been active before pregnancy may continue with the exercises. But, those who are new to exercise must get advice on the exercise regimen from an expert. Here is an account of the benefits and the risks associated-

Benefits of exercise on the mother’s emotional health
Various studies have shown that women who keep themselves physically fit during pregnancy are generally more relaxed, and thus they can cope better with the psychological and emotional strains of pregnancy.

Women, who work out throughout pregnancy develop a better sense of wellbeing owing to a wide array of positive effects from exercise such as controlling weight and maintaining body image and self-esteem. It also helps improve sleep. Further, it is believed that the positive effects stay even after delivery, which may reduce the incidence of postnatal depression.

It is a proven fact that women who exercise during pregnancy experience increased muscular and cardiovascular strength and fitness. It also improves posture owing to the increase in abdominal and upper body strength. Exercising during pregnancy improves blood circulation, which, in turn, can prevent varicose veins as well as deep vein thrombosis. It also helps reduce instances of constipation and swelling. Furthermore, expectant mothers experience less pain during labor along with reduced medical interventions. It is also proven that the mothers, who work out regularly, give birth to an emotionally and physically healthy baby.

Risks of exercising during pregnancy-
Though exercise is proven to be a safe means of mitigating various problems, it can bring about some risks and complications as well.

The hormones which are stimulated during pregnancy can induce premature contractions. Also, it causes an increase in glucose consumption for helping the fatigued muscles to cope up. It may affect the glucose level of the fetus as well. Overheating while exercising can disrupt the maternal thermoregulation to a great extent. Therefore, one should refrain from strenuous workouts or work out in high temperatures.

A few specific risks-
Exercise during pregnancy is not advisable when you have medical conditions like asthma, Type I diabetes or heart disease. Also, women with obstetric conditions such as bleeding or spotting, and weak cervix must refrain from exercising.

It is necessary to take an opinion from your gynecologist before you start with your exercise plan. Particularly, when you wish to do aerobic exercises, it is quite necessary to consult your doctor as the exercises may not suit you under several conditions.

Thus, staying active with an exercise plan is beneficial, but with necessary care and guidance, of course.
 

1369 people found this helpful
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