Recurrent and late miscarriage: tests and treatment of couples

DR. (Mrs.) PULKIT NANDWANI

MD, MRCOG( LONDON), DMAS( WALS)

DIPLOMA IN LAPAROSCOPY ( FRANCE )

Senior Consultant,

Obstetrician, Gynaecologist and Laparoscopic Surgeon

Specialist in Minimally Invasive Gynaecological Surgery

Synergy Clinic- 

E-15, 123 & 124, ground floor, Sector 8, Rohini, Delhi – 85

Ph:- 9971573637, 01127943745

Recurrent and late miscarriage: tests and treatment of couples

Having a miscarriage can be very distressing. To have several miscarriages or a late miscarriage can be devastating. There is a requirement to consult a gynecologist and a obstetrician nearby you. 

What is a miscarriage?

 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.

 What is recurrent 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)-  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-  In 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

• Weak cervix-  Weakness of the 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-  Some abnormalities of the baby may lead to a miscarriage but are unlikely to be the cause of recurrent miscarriage.

 • Infection - Any 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.

 • Shape of the uterus-  It is not clear how much an abnormally shaped uterus contributes to recurrent miscarriage or late miscarriages. However, minor variations do not appear to cause miscarriage.

 • Diabetes and thyroid problems

• Immune factors -  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.

Other risk factors?

Being overweight

 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.

Why are investigations helpful?

 Finding out from the best gynecologist in Rohini,  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 .

 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.