Miscarriage is the natural loss of a baby in its mother’s womb before 24 weeks and may happen even without a woman is aware that she is pregnant. This usually occurs in the first trimester (13 weeks) of pregnancy. Symptoms include vaginal spotting or bleeding, abdominal pain or cramping, and fluid or tissue passing from the vagina. If you have any of these symptoms, you should call your doctor, who may do an ultrasound exam and a pelvic exam to confirm the miscarriage.
Most miscarriages are caused due to genetic abnormalities that occur by chance and are not related to the mother’s or father’s health. Other causes include infection, certain medications, hormonal effects, structural abnormality of the uterus, and disease conditions such as severe kidney disease, congenital heart disease, and uncontrolled diabetes.
Recurrent miscarriage, also known as recurrent pregnancy loss or chronic abortion, happens when a woman experiences two or more clinical pregnancy losses in a row. A clinical pregnancy is defined by doctors as having clinical evidence of pregnancy, such as visual or laboratory signs of the gestational sac (cavity of fluid enclosing an embryo), placenta, or fetal pole (thickening on the border of a fetus's yolk sac) on an early ultrasound.
Clinical pregnancies are distinct from chemical pregnancies, in which a miscarriage happens before there is any sign of pregnancy other than a positive pregnancy test or blood test. Miscarriages account for 15 to 20% of all clinical pregnancies.
A fertility expert or an ob/gyn will analyze a patient's medical history and previous pregnancies to establish the cause of recurrent miscarriages. A comprehensive physical check, including a pelvic exam, is frequently recommended by a doctor.
If the repeated miscarriages are considered to be caused by a genetic defect, the doctor may order a karyotype, which is a test that identifies and assesses the size, shape, and number of chromosomes in a sample of body cells.
If a doctor feels a uterine disease is causing recurrent miscarriage, he or she would most likely order imaging tests, such as an MRI or a sonogram/ultrasound. A hysterosalpingogram (HSG) (an X-ray of the fallopian tubes and uterine cavity) or an ultrasound can determine if a woman has a uterine shape problem. A doctor may order blood testing to diagnose immune system issues such as APS.
Approximately half of all patients evaluated for recurrent miscarriage receive a definitive diagnosis. The remaining patients do not have a clear etiology for their recurrent miscarriage.
Among patients who do not know the source of their diagnosis, the possibility of a successful future outcome might be as high as 70%, depending on the patient's mother's age.
Recurrent miscarriage treatments may include lifestyle modifications, drugs, surgery, or genetic testing to boost the chances of a successful pregnancy. Medical or surgical therapies for some diseases associated with recurrent miscarriage can reduce a woman's risk of future miscarriage.
A woman has a 60 to 80 percent probability of conceiving and carrying a full-term pregnancy even after three miscarriages. Women frequently elect to continue trying to conceive naturally, but in some cases, a doctor may recommend therapies to help lower the risk of recurrent miscarriage.
Surgery can correct septate uterine issues and remove certain fibroids or scar tissue defects. Surgical correction is frequently the therapy of choice for anatomical abnormalities because it increases the number of live births.
A doctor may prescribe blood thinning drugs, such as low-dose aspirin or heparin, if the patient has an autoimmune disorder, such as APS. Although blood thinning drugs can be used during pregnancy to reduce the risk of miscarriage, the increased risk of significant bleeding problems should be discussed with a doctor before using them.
Treatment of medical conditions such as high blood sugar levels, thyroid difficulties, or hormonal imbalances might increase the likelihood of delivering a healthy, full-term pregnancy. This process can be aided by medications that activate dopamine receptors in the brain or progesterone supplements.
If a doctor discovers a chromosomal issue, such as translocation, he or she may suggest genetic counseling. While many couples with translocations conceive naturally, a doctor may recommend fertility procedures such as in vitro fertilization (IVF), which involves a reproductive specialist combining eggs and sperm in a lab. Only normal embryos are then put to the uterus after being genetically screened using a procedure known as preimplantation genetic diagnosis (PGD). This raises the chances of a successful pregnancy.
Making healthy lifestyle choices, including as quitting smoking or using illicit drugs, limiting alcohol and caffeine, and maintaining a healthy weight, may reduce the chance of recurrent miscarriage. There is little evidence that stress, worry, or mild depression contribute to recurrent miscarriages.
These may be due to genetic conditions, maternal ill health, and a variety of other conditions that may need further specialized investigations, that will be discussed with you by Dr. Elsa a specialist for miscarriage in Dubai.
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