What is Recurrent Miscarriage?
A miscarriage is the spontaneous loss of a pregnancy before the 20th week. Anywhere between 10 and 20% of known pregnancies end in miscarriage, meaning this is unfortunately a relatively common experience—though this does not make it easier. The name might imply that something went ‘wrong’ during the carrying of your pregnancy, but this is rarely true. Most miscarriages occur because the foetus hasn’t developed as expected, and this is not your fault.
Miscarriage is typically a one-time occurrence, and most women who miscarry go on to have healthy pregnancies in the future. Less than 5% of women will have two consecutive miscarriages, and only 1% of women will have three or more—this 1% represents what health professionals call recurrent miscarriage. Take a step towards emotional healing by understanding the potential causes behind miscarriage, and what medical options are available to you.
What Causes Recurrent Miscarriage?
Miscarriage itself is generally understood, though the potential causes behind one can be rather varied. About fifty percent of miscarriages are associated with chromosomal problems, with extra or missing chromosomes causing errors by chance as the embryo grows. This rarely has to do with genetic inheritance from the parents. In some cases, miscarriage might be caused by uncontrolled diabetes, hormonal problems, thyroid disease or uterine abnormalities.
Certain factors can increase the risk of miscarriage, including chronic health conditions, the use of drugs and alcohol during pregnancy, and your age. If you are older than 35, or have a history of uterine and cervical problems, your risk of miscarriage is generally considerably higher.
The causes of recurrent miscarriage are more elusive, as something that causes one miscarriage does not necessarily mean it will a second or third time. It is not always possible for doctors to discover why this is happening, but some suggested causes are outlined below:
- Blood disorders. Some blood clotting disorders such as lupus, or antiphospholipid syndrome can cause recurrent miscarriage. These are disorders of the immune system that affect the flow of blood to the placenta, and may prevent it from functioning properly. This can deprive the baby of essential nutrients and oxygen, which might lead to a miscarriage. If you have been diagnosed with recurrent miscarriage, you should be screened for these conditions, and you may be treated with blood thinners to rectify the problem.
- Thyroid problems. Thyroid complications have been linked to an increased risk of pregnancy loss and other issues. It is easy and often straightforward to test and treat thyroid issues before getting pregnant.
- Thyroid antibodies. These molecules in the bloodstream might attack your thyroid, causing it to work improperly.
- Uterine abnormalities. In some cases, an unusually shaped womb can increase your risk of miscarriage or premature birth. This is usually diagnosed with an ultrasound, and depending on the nature of your abnormality, you may be recommended surgery—though this can come with its own risks of infertility.
- Genetics. In a small number of cases, one or both partners in a pregnancy may repeatedly pass on abnormal chromosomes, causing recurrent miscarriage. You may be offered a blood test to check for abnormalities within your chromosomes, and if the tests reveal a problem, you will likely be referred to a geneticist.
- Weakness of the cervix. If you have a history of miscarrying late into your pregnancy and considered at risk for cervical weakness, you may be offered a scan to assess the length of your cervix. Depending on your medical history and the findings of the scan, you may be advised to have a cervical cerclage (or stitch) before or during your pregnancy.
How Can You Cope with Recurrent Miscarriage?
Miscarriage is an upsetting and emotional thing to go through, especially if you aren’t sure why it is happening to you. Following recurrent miscarriages, healthcare professionals will continue to try and identify root causes, and you may be referred to a specialist unit dedicated to managing the issue. You might be offered progesterone hormone treatment—recent research in the United Kingdom has suggested that women with three or more previous miscarriages, given progesterone pessaries twice daily, experienced a 15% increase in their live birth rate when compared to those untreated.
Often, however, the most important thing to treat following recurrent miscarriage will be your own emotions. You may feel grief, shock, anger or anxiety that this keeps happening to you. But you should know that you are not alone. Talk about your feelings with your partner, your healthcare professional, or other women who have experienced similar situations. There are always avenues for advice and emotional support. If you or your partner are struggling to cope, contact your doctor. They will be able to direct you towards support, or refer you to other specialists.
If you are experiencing Recurrent Miscarriages, make an appointment with Dr.Nicole Stamatopoulos here.