Introduction
It is a recurrent pregnancy loss if a person experiences three or more miscarriages. This is often rare and affects one percent of couples. Having a recurrent miscarriage can be a very traumatic experience. So if a person has experienced three or more pregnancy losses in a row, they should be referred to a specialist to manage recurrent miscarriages. This article explains more about recurrent miscarriages.
What Is Recurrent Pregnancy Loss?
Recurrent pregnancy loss, also called recurrent miscarriage or habitual abortion is defined as the experience of three or more successive pregnancy losses. When a clinically-recognized pregnancy ends involuntarily before 20 weeks of pregnancy is called pregnancy loss. A pregnancy loss is clinically-recognized when it has been picturized on an ultrasound or the pregnancy tissue was found after a pregnancy loss.
How Is Common Recurrent Early Pregnancy Loss?
Studies have shown that about two percent of women experience recurrent pregnancy loss. However, 0.5 percent of women experience more than two recurrent miscarriages, which may indicate problems with reproductive systems. So, a complete medical examination is recommended after three consecutive pregnancy losses.
What Are the Types of Recurrent Miscarriages?
Recurrent pregnancy loss is divided into two categories, that includes:
-
Recurrent Early Pregnancy Loss - The pregnancy loss that occurs within the first trimester is called recurrent early pregnancy loss. This is commonly due to chromosomal or genetic abnormalities of the fetus. Structural anomalies of the uterus also play a crucial role in early pregnancy.
-
Recurrent Late Pregnancy Loss - The pregnancy loss that occurs after week 13 or during the second trimester of pregnancy is called recurrent late pregnancy loss. This can result from autoimmune problems, uterine abnormalities, an incompetent cervix, or trauma.
What Are the Symptoms of Recurrent Early Pregnancy Loss?
Each miscarriage may be different. Some may experience bleeding with pain, while others may have no symptoms. Typical symptoms of pregnancy loss include:
-
Bleeding or spotting.
-
Vaginal mucus discharge that appears whitish pink.
-
Tissue that looks like a blood clot passing from the vagina.
-
Mild-to-severe back pain.
-
Painful contractions.
What Are the Causes of Recurrent Early Pregnancy Loss?
The most common causes of recurrent early pregnancy loss are as follows:
1) Genetic - The chromosomal issues of the embryo are common and consist of 50 to 80 percent of all first-trimester pregnancy losses. However, sometimes some chromosomal abnormalities are repeatedly passed from one or both partners, which can contribute to recurrent pregnancy losses. If someone experiences two or more losses, they should consider a karyotype to check for chromosomal abnormalities. If the karyotyping shows some problem, the couples should be referred to a geneticist for further testing.
2) Uterine Problems - Any uterus shape and structural abnormalities can increase the risk of pregnancy loss. The abnormalities can usually be found with an ultrasound scan. Depending on the finding of the abnormality, surgeries may be recommended to fix it.
There are also problems with polyps or fibroids for some women. These are growths that can occur within the uterus, which can cause problems with pregnancy, but most of the time, the fibroids do not cause any harm.
Intrauterine scarring can also lead to pregnancy loss. Most of these problems can be solved before conception through surgery, thus increasing the chances of a healthy pregnancy.
3) Blood Clotting Disorders - There can be clotting in the blood vessels of the fetus due to the antibodies produced by the mother that can affect the developing fetus. As a result, the fetus will not get enough nutrients and dies in the womb, causing a miscarriage. This is due to the immune system affecting the blood flow to the placenta and causing blood clots that prevent the placenta from properly functioning. Blood tests can determine the cause if a person has undergone three or more pregnancy losses. The treatment will be with the help of anticoagulants like Aspirin or Heparin.
4) Endocrine Issues - Endocrine issues can include disease of the pituitary and thyroid glands, polycystic ovarian syndrome, or diabetes. Thyroid problems have been connected to an increased risk of miscarriage and other pregnancy complications. They can be easily diagnosed with a blood test and are straightforward to treat. It is necessary to have a check for healthy thyroid functioning before getting pregnant.
5) Environmental Factors - Certain drugs, chemicals, x-rays, etc., can also increase the risk of pregnancy loss. Some of these factors are lifestyle-related, while others may be related to work. Excess use of caffeine or alcohol and smoking may impact pregnancy outcomes. Increased weight (obesity) is also associated with an increased risk of pregnancy loss.
6) A High Number of Previous Pregnancy Losses - The risk of pregnancy loss increases after each consecutive loss. For example, women with three pregnancy losses in a row have a four in ten chance of having another one. This indicates about 60 percent of women will go on to have a baby next time.
What Is the Treatment for Recurrent Early Pregnancy Loss?
If a woman has experienced two or more miscarriages, consulting a healthcare provider is very important. The doctor might suggest treatments to reduce the risk of miscarriage that includes:
1) Surgery - Surgery is done to fix some problems in the uterine abnormalities, like some fibroids (benign tumors) or tissue that separates the uterus (septum) or scar tissue. Correcting the shape of the uterus can often decrease the chance of miscarriage. Normally, a hysteroscope (an instrument with an attached camera) is used by the surgeon to repair the inner side of the uterus.
2) Anticoagulants - Women with clotting (thrombophilia) or autoimmune problems can be treated with Heparin and low-dose Aspirin. These drugs can be taken during pregnancy to decrease the risk of miscarriage.
3) Medical Conditions - Recurrent early pregnancy loss can be due to some medical problems. These include an over-or underactive thyroid gland, abnormal blood sugar levels, or high levels of the prolactin hormone. So it is necessary to treat medical conditions such as thyroid dysfunction, diabetes, or high prolactin levels that can enhance the chances of having a healthy pregnancy.
4) Genetic Screening - In about five percent of couples with recurrent pregnancy losses, any of the parents might have a rearrangement of their chromosomes, known as translocation. This can cause chromosome imbalances in fetuses that lead to pregnancy loss. Fertility treatments, such as in-vitro fertilization (IVF), will be helpful for a healthy pregnancy. During IVF, sperm and egg are mixed in a laboratory, and then the embryos are tested (preimplantation genetic screening) and returned to the uterus.
5) Lifestyle Changes - Stopping cigarette smoking and illicit drug use will decrease the risk of miscarriage. Also, stopping alcohol and caffeine intake will be helpful. Being obese has been associated with an increased risk of pregnancy loss, so healthy weight loss can also help in pregnancy outcomes.
Conclusion
Two or more consecutive pregnancy loss during the first trimester of pregnancy is called recurrent early pregnancy loss. It can be mainly due to genetic and chromosomal issues. Uterine abnormalities and lifestyle changes can also play a role in miscarriage. It is important to stay mentally strong and consult a doctor to diagnose the cause and have the correct treatment to help a healthy and full-term pregnancy.
