Miscarriages are common, occurring in 15-20% of all pregnancies, usually in the first trimester (up to 12 weeks). A diagnosis of recurrent pregnancy loss (RPL) could be considered after the loss of two or more pregnancies.
Types of Miscarriage:
Early Miscarriage: Miscarriage occurring within 12 weeks of pregnancy. Most commonly due to genetic or chromosomal problems of the embryo, with 50-80% of spontaneous losses having abnormal chromosomal number. Problems of uterus like adenomyosis or endometritis can also contribute to early miscarriage.
Late miscarriage: results mainly due to structural abnormalities of uterus, autoimmune problems of the mother or an incompetent cervix.
Finding a cause
A history of recurrent miscarriage calls for evaluation and management. Tests are done on mother, father and fetal tissue (when possible).
Repeated miscarriages can happen because of any of the following:
- Chromosomal abnormalities (increased aged of the parents, genetic problems of the parents or the fetus itself)
- Immune problems
- Metabolic and Endocrine issues (Polycystic Ovary Syndrome, Thyroid dysfunction, Prolactin disorders, luteal phase defects, Diabetes mellitus, Hyperhomocyteinemia, decreased Vitamin D levels)
- Antiphospholipid antibodies
- Problems in the uterus (infections, structural defects, adenomyosis, fibroids)
- Physical Illness
- Life style of the woman (excess use of alcohol, caffeine, smoking, obesity and high stress levels)
- Environmental factors like exposure to certain chemicals, drugs , X- rays, etc.
Often, the reasons are unknown about multiple miscarriages. Even after two miscarriages, there is high chance of a successful pregnancy even without any specific treatment and with just reassurance!! Be strong and hopeful and consult a doctor who has specialization in high risk obstetric care.