Recurrent miscarriage, causes and treatment

What is a miscarriage?

A miscarriage is a pregnancy loss during the first 23 weeks of pregnancy.

The main symptom of a miscarriage is the vaginal bleeding which can be combined with cramping and pain in the lower abdomen.

However, the presence of light bleeding (spotting) is common during the first trimester (the first 12 weeks) and it does not mean that associated with a miscarriage.

A miscarriage is a very common event which occurs in about 15% of pregnancies. However, the frequent miscarriages (several pregnancy losses in short period of time) may occur due to an underling medical problem.

The women who experience recurrent miscarriages should be investigated in order to find the root cause when possible.

Does it matter in which stage of pregnancy the miscarriage occurs?

More than 75% of miscarriages happen during the first trimester of pregnancy.

The gestational week that a pregnancy loss occurs give more information about the causes.

In a normal pregnancy the heartbeat should be detected at around 6 weeks from the first day of the last period.

It helps us to investigate the underlying cause of a miscarriage if we know when the pregnancy loss occurred (before or after the fetal heartbeat detection).

Generally, as later in pregnancy a miscarriage occurs, the less the risk of genetic abnormality.

What is a biochemical pregnancy?

A biochemical pregnancy takes place before ultrasound scan can detect the fetal heartbeat and the only sign of pregnancy is a positive pregnancy test (high hCG levels).

It is a very early miscarriage and after a few days the test provides a negative result.

Common causes

• Fetal chromosomal (genetic) abnormalities. Approximately, 60% of miscarriages have genetic causes. The advanced maternal age increases the risk of genetic problems in the fetus
• After the age of 42, the women have a higher risk of miscarriages which reaches the 50%
• Chromosomal abnormality in one or both of parents
• Uterine abnormalities. Fibroids or congenital malformations such as uterine septum (this kind of abnormalities can be managed through surgical procedure named hysteroscopy)
• Diseases such as diabetes or thyroid abnormalities
• Thrombophilia (increased risk to form clots)
• Autoimmune diseases such as antiphospholipid antibody syndrome
• The interaction between mother immune system and fetus it is a really controversial issue

According to updated literature, there is no immunological interaction between mother and baby and as a result there is no recommended treatment for mother immunosupression.

However, in some cases mother’s immune response changes should be tested and a mild short- time treatment might be suggested.

Undoubtedly, the treatment should be personalized.

How could I decide which option is better for me?

Consult Dr. Marinakis. Start with a targeted investigation for the root causes of recurrent miscarriages.

The solution to the problem lies within the proper investigation and finding the root causes of the recurrent miscarriages.

The gynecologist Dr. Marinakis served as special assistant in the department of Recurrent Miscarriages in University Hospital St. MARY'S HOSPITAL, LONDON, which is an international center of interest due to the research and scientific publications in the field of reproductive medicine and recurrent miscarriages.