Repeat Miscarriage

Spontaneous abortion is the medical term used to describe miscarriage. Simply, it means that a pregnancy is lost. Most occur in the first trimester. This event occurs in from 15 - 20% of all recognized pregnancies. It's real frequency is likely much higher because not all pregnancies will or can be detected.

Three or more losses are required to fit the diagnosis of "repeated pregnancy loss", but evaluations for possible causes are usually begun after two losses due to the emotional impact and psychological overlay involved with the event in effected couples.

Most often, no cause(s) are found. In general, we look for some of the more common areas that have been proven to increase the chances of miscarriage. Those areas include:

• chromosomal abnormalities in one/both of the parents
• illness in the mother
• hormone imbalances
• anatomic problems involving the uterus
• disorders of the maternal immune system
• possible environmental or life style issues

Over 60% of losses occur as the result of a non-recurring problem with chromosome number or structure leading to the loss. These generally occur by chance and are not likely to recur. After three losses, the chances of finding an abnormality in either member of the couple are less than 10%. Parental chromosomes can be tested through blood samples taken and specially prepared for evaluation.

We can evaluate embryonic chromosomes if the pregnancy developed beyond a certain point. Remember, most losses are due to chance abnormalities in the development of a new chromosome pattern.

Maternal Illness

Chronic and uncontrolled illnesses may predispose to pregnancy loss. These include:

• Diabetes mellitus
• Thyroid disease Kidney disease/high blood pressure
  
• Heart disease
  
• Liver disease
  
• Autoimmune disease such as Lupus erythematosus

Hormone Imbalances:

Luteal phase deficiency is a condition where the lining of the uterus develops inappropriately to circulating progesterone levels. There may be inadequate levels or an inappropriate response to otherwise normal levels of progesterone. The lining may be evaluated by transvaginal ultrasound or, in some instances, endometrial biopsies.

Uterine Anatomic Problems:

• Congenital developmental abnormalities such as a septate uterus or a bicornuate uterus
• Uterine fibroids (muscle tumors or growths), polyps, or scar tissue from previous surgical procedures

Immune System Disorders:

• Anti Phospholipid Syndrome
• Anticardiolipin antibodies
• Lupus anticoagulant
• Perhaps thyroid

Site Index