One of the biggest fears of women whose first pregnancy ended in miscarriage is that they will never have another child or that their next pregnancy will also end in miscarriage. This is not real. However, women who have had a miscarriage are slightly more likely to have a miscarriage or threatened miscarriage in subsequent pregnancies than those who have never had one. When 3 or more consecutive pregnancies end in miscarriage, it is called recurrent miscarriage. The important point here is that miscarriages occur in consecutive pregnancies, that is, back to back.
Causes of Recurrent Miscarriages
Uterine anomalies: Recurrent In approximately 12-15 percent of women with miscarriage, the problem originates from the uterus. The condition known as double eye in the uterus or the cervix being dilated too much may result in recurrent miscarriages. To understand this, it is necessary to evaluate the cervical opening and take a uterine x-ray.
If the problem is cervical insufficiency, the pregnancy can be brought to term with a stitch (cerclage) placed in the early period of pregnancy. For those with a double-looped uterus or a similar deformity, operations are planned to eliminate this.
Hormonal Causes: An important reason for recurrent miscarriages is hormonal disorders. Many hormone disorders can cause miscarriage. For example, decreases or increases in thyroid hormones may cause miscarriage. Treating this condition usually ensures that the pregnancy continues without any problems. Insufficiency of the progesterone hormone, which is secreted first from the ovaries and then from the placenta and whose function is to maintain pregnancy, also results in miscarriage. The treatment of this condition, called luteal phase failure, is to administer the missing hormone externally.
Chromosomal causes: One of the most important causes of miscarriage is chromosomal disorders. If there are genetic disorders that can be passed on to subsequent members of the family, this may be the cause of recurrent miscarriages. When such a situation is suspected, chromosome analysis is performed on the spouses and if pathology is detected, genetic counseling is required.
Coagulation Tendency: The baby in the womb is connected to its mother by the placenta. Between baby and mother Current nutrition and blood exchange occurs through capillaries in the placenta. When people with coagulopathy become pregnant, very small clots form in these capillaries and cause blockage. This situation disrupts the baby's nutrition and therefore its development, and eventually miscarriages occur. In women with recurrent miscarriages, tests such as aPTT, anticardiolipin antibodies, Lupus anticoagulant are also required. In addition, they must undergo a complete general examination and have blood tests, especially a complete blood count. Apart from thrombophilia, there may also be a tendency to clot in some other blood diseases. It should be examined whether the expectant mother has such blood diseases. Afterwards, it should be evaluated by a hematologist and gynecologist and appropriate treatment should be started.
Treatment for Recurrent Miscarriage
Treatment recommendations for patients with recurrent pregnancy loss depend on the underlying cause of recurrent pregnancy loss. It endures. People with a karyotypic (chromosomal or genetic) abnormality usually undergo genetic examination. If there is a genetic abnormality, it is detected and the possibility of having a chromosomally normal or abnormal pregnancy in the future is investigated. If a uterine abnormality is found, surgery may be performed depending on the defect. Once the individual causes of pregnancy loss are identified, the risk of miscarriage can be prevented with a treatment plan tailored to the diagnosed problem.
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