Recurrent Pregnancy Loss
Recurrent Pregnancy Loss Takes An Enormous Toll On Women, Still A Taboo Worldwide
You are pregnant and thrilled with excitement and lot of dreams. You are just getting used to the idea; your husband and family are excited. A new future stretches ahead. And then it all goes wrong. You unfortunately miscarry. There’s no baby, no motherhood and often, lots of painful questions to answer. It is emotionally, physically & financially devastating to the couple & family. Not everyone responds to miscarriage in same way and there is no right or wrong way. But for most, there is need to grieve.
Losing a baby in pregnancy through miscarriage or stillbirth is still a taboo subject worldwide, linked to stigma and shame. Many women still do not receive appropriate and respectful care when their baby dies during pregnancy or childbirth.
Miscarriage is the most common reason for losing a baby during pregnancy. Estimates indicates a miscarriage rate of 10-15% in women who knew they were pregnant. Pregnancy loss is defined differently around the world, but in general a baby who dies before 28 weeks of pregnancy is referred to as a miscarriage, and babies who die at or after 28 weeks are stillbirths. Every year, nearly 2 million babies are stillborn, and many of these deaths are preventable. However, miscarriages and stillbirths are not systematically recorded, even in developed countries, suggesting that the numbers could be even higher.
Dr Ria Vaidya, CEO, Horizon Group of Hospitals said “Recurrent Pregnancy Loss takes an enormous toll on women. Many women who lose a baby in pregnancy can go on to develop mental health issues that last for months or years– even when they have gone on to have healthy babies. There are many reasons why a miscarriage may happen, including fetal abnormalities, the age of the mother, and infections, many of which are preventable such as malaria and syphilis, though pinpointing the exact reason is often challenging. General advice on preventing miscarriage focuses on eating healthily, exercising, avoiding smoking, drugs and alcohol, limiting caffeine, controlling stress, and being of a healthy weight. This places the emphasis on lifestyle factors, which, in the absence of specific answers, can lead to women feeling guilty that they have caused their miscarriage”.
Dr Ria Vaidya further said “As with other health issues such as mental health, around which there is tremendous taboo still, many women report that no matter their culture, education or upbringing, their friends and family do not want to talk about their loss. This seems to connect with the silence that shrouds talking about grief in general”.
Dr Manali Shilotri, Leading Gynaecologist and Consultant Horizon Prime Hospital said “Miscarriage is defined as the loss of a pregnancy before 26 to 28 weeks of gestation. It is one of the common complications of pregnancy. It may also happen that approximately 25% of women who become pregnant will experience at least one miscarriage. Nearly 20% of pregnancies end in miscarriage, most often within first 12 weeks. Recurrent miscarriage, or habitual pregnancy loss, is defined as three or more consecutive, spontaneous pregnancy losses. However, recurrent miscarriage is seen in only 1% of couples”.
Dr Manali Shilotri further said “There is no single cause for recurrent miscarriages. Depending on time of pregnancy loss, history and investigations, the main causes could be genetic, infective, hormonal, thrombophilic (blood clotting problems), structural, infective and many others. Many cases are unexplained with no apparent cause”.
Dr Hrushikesh Vaidya, Medical Director and Chairman Horizon Group of Hospitals said “The current burden for recurrent pregnancy losses in India is quite high and is around 7.4 per cent, as per available government data. The majority of them have no definitive cause for pregnancy loss even after a complete repeated pregnancy loss workup. Traditionally, chromosome polymorphism have been considered normal variants without clinical significance. Recently Redcliffe Labs as per the newspaper reports identify the high prevalence of chromosomal polymorphism in couples with recurrent pregnancy loss. It clearly indicates that chromosome polymorphism plays a more significant role than previously thought. Even though, more research is still needed on this, but the findings will enable doctors to counsel patients and undertake timely clinical interventions for couples planning future pregnancies after unexplained repeated pregnancy loss.”
Risk Factors
- Old age
- Previous pregnancy losses
- Uterine anomalies
- Endocrine disturbances
- Lifestyle and obesity
Symptoms
Each miscarriage you have may be different. Typical symptoms of a miscarriage include:
- Spotting or bleeding
- Painful Contractions every 5 to 20 minutes
- White-pink mucus discharge from the vagina
- Vaginal tissue that resembles a clot passing from the vagina
- Mild-to-severe back pain
Causes
While often the reasons for miscarriage are not obvious, it is worthwhile to look more closely at possible causes if you have not had a live birth and have had two or more miscarriages. Here are a few potential reasons for miscarriage:
- Genetic – Random embryonic chromosomal abnormalities are frequent and account for 50-80% of all first-trimester losses.
- Uterine anomalies – A septate uterus, a double uterus, a uterus divided by a wall, or other less frequent congenital issues might result in recurring losses in about 15% of cases.
- Endocrine issues – Investigations into endocrine conditions are warranted in cases of thyroid and pituitary gland disorders, diabetes, or polycystic ovarian syndrome.
- Autoimmune diseases – When a mother or carrier develops antibodies that subtly cause blood vessels to clog, a developing fetus is deprived of nutrition and is at risk for immunological issues.
Treatment Options
If you have suffered two or more miscarriages, you should talk with your healthcare provider. Some of the available treatments for pregnancy loss include:
- Surgery – Surgery can fix some problems in the uterus (womb), like extra tissue that divides the uterus (septum), some fibroids (benign tumors), or scar tissue.
- Blood-thinning medicines – Women with autoimmune or clotting (thrombophilia) problems may be treated with medicines.
- Correcting other medical problems – Treating medical conditions such as diabetes, thyroid dysfunction, or high prolactin levels can improve the chances of having a healthy, full-term pregnancy.
- Genetic screening – The parents’ blood can be studied to see if they have a translocation.
- Lifestyle Choices – Get Fit. Stopping smoking and illicit drug use and this will lower the risk of miscarriage.
Conclusion
The psychological and emotional impact of recurrent pregnancy loss is significant for couples. Getting to the root of repeated miscarriages requires seeking a physician with expertise in this area. If you suffer two or more miscarriages, then you should seek a specialist. Horizon Prime Hospital Women’s Wing provides latest scientific evidence based approach towards recurrent miscarriage patients. As each patient is entirely unique in terms of their clinical problems hence dedicated consultations, targeted investigations, individualized treatment and care plan is offered to every couple. We are dedicated in diagnosing and treating miscarriages and provide you with the highest chance of having a successful pregnancy outcome. The clinic is supported by the state-of-the-art laboratory facilities, neonatal care and all modern facilities to look after the women in pregnancy and labour for successful neonatal outcome.
