Thursday, April 9, 2015

Repeated (Recurrent) Miscarriages and Further Investigation

Repeated Miscarriages are one of the most disappointing experiences a couple can have when trying for a baby. In most cases, especially if the miscarriages occur during a natural pregnancy, patients may believe that this is a normal phenomenon and they should keep trying. We have treated many patients who had experienced more than 10 miscarriages when trying for a baby without receiving proper support or information from their health care provider.

Repeated miscarriages can be labeled as such if the patient has had three or more consecutive miscarriages. Having had only one miscarriage will not call for additional testing and investigation as that is something a large number of women experience at one point during their lifetime and it has been shown that women who have a single miscarriage will go on to have a healthy full-term pregnancy afterwards. However, if the patient keeps having miscarriages one after another, there is usually a medical condition behind it which needs to be investigated.

One of the first things that needs to be established is when the patient is experiencing her miscarriages. Certain times of gestation may point to different underlying causes behind the patient's miscarriages. If the patient has experienced her pregnancy losses after 12 weeks of gestation, then there is a high likelihood of cervical incompetence as the underlying cause. Cervical incompetence can be diagnosed through testing when the patient is not pregnant or via close monitoring during pregnancy.

When the patient experiences her miscarriages earlier on, during the first trimester, then other possible problems are accentuated. For instance, genetic problems with gametes (sex cells) could be one problem. Also, the couple may have chromosomal problems that show no symptoms but cause problems during reproduction (such as reciprocal translocations). Alternatively, thrombophilic defects that cause clotting problems are one of the main factors behind first trimester pregnancy losses.

A number of precautionary measures can be taken prior to or during your pregnancy in order to minimize the risk of yet another miscarriage. However, the underlying reasons must be well investigated and understood so that appropriate measures can be taken. For more information, please visit our website.