Early pregnancy losses are an extremely demoralizing situation for both the patient and the doctor. Early pregnancy loss occurs in 75% of women who want to become pregnant. Since most of these losses occur during the woman's menstrual period, it is not possible for the woman to notice this. If the loss occurs before the 12th week of pregnancy, it is called early pregnancy loss.
Spontaneous miscarriages that occur at least three times in a row are called recurrent pregnancy loss or habitual abortion.
When there is no pregnancy diagnosis yet with clinical and imaging techniques, only a positive pregnancy test is called chemical pregnancy. This is often due to defects in the sperm and egg.
Recurrent pregnancy loss causes are:
Genetic causes:
Anatomical disorders in the uterus
Problems concerning the immune system
Endocrine problems
Hematological causes
Infections
Environmental causes
Genetic causes generally occur due to the abnormal chromosome structure of the embryo with increasing age. This is the reason for 70% of early pregnancy losses. In cases of early pregnancy loss, genetic analysis of the miscarriage material may be performed. Useful information can be obtained for the next pregnancy. Although efforts are being made to reduce recurrent pregnancy losses through preimplantation genetic diagnosis and assisted reproductive techniques, biopsies taken at four and eight cells may not fully reflect the karyotype due to the risk of not all cells being similar. In couples with recurrent miscarriages, there may be chromosomal disorders of the mother or father. While this does not cause any errors in the individual, it may become evident during pregnancy and cause births that are incompatible with life. These couples should be given genetic counseling.
Anatomical causes are encountered in every 700 women. The prevalence rate of anatomical disorders such as septum, bicornuate and arcuate uterus in the society is 6.7%. These disorders negatively affect the area where the fetus will be placed, either by negatively affecting the vascularity or by narrowing the uterine cavity. Intrauterine adhesions, fibroids and endometrial polyps are other causes of recurrent miscarriage. Surgical correction of these abnormalities reduces the miscarriage rate.
It is known that the immune system plays a key role in successful pregnancy. The relationship between immune system diseases and recurrent pregnancy loss has been known for many years. The increased risk of miscarriage in systemic lupus erythematosus is well known.
Uncontrolled diabetes, insufficient progesterone levels, and luteal phase disorders are endocrine problems that can be considered as the cause of miscarriage. The relationship between thyroid-related diseases and miscarriages is not clear. However, the presence of antithyroid antibodies may be a sign of other autoimmune diseases.
Meta-analyses have shown that hereditary and acquired thrombophilia disorders such as factor V Leiden mutation, activated protein C resistance, prothrombin gene G20210A mutation and protein S deficiency are directly related to recurrent pregnancy losses.
Although there are many microorganisms accused of causing recurrent pregnancy loss, there is no consensus on an agent. The role of infections in this regard is very limited.
Lead is a well-known nerve damager. Again, although discussions on smoking are not certain, they may slightly increase the risk of miscarriage.
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