Recurrent Pregnancy loss: what to do ?

Recurrent pregnancy loss is termed as the condition in which there is the loss of two or more consecutive pregnancies. A pregnancy loss is marked clinically when the pregnancy involuntarily ends before 20 weeks.

Causes:

• pregnancy loss may be a result of several factors like genetic abnormalities, chromosomal defects other random events. The ovum, sperm, or the early embryo might also be accountable for these abnormalities. With an increasing maternal age, the risk of miscarriage also increases, which may occur because of poor egg quality resulting in chromosomal or genetic abnormalities. In certain cases, either of the parents may have mutations in their genes, however, the offspring could be more severely affected ultimately resulting in miscarriage.
• Any abnormality present in the uterus may also lead to miscarriage. The reasons may be poor blood supply or infection in the uterus. Some women have a congenitally abnormally shaped uterus or might develop abnormalities in their uterus over time.
• Hormonal imbalances that commonly occurs in diseases like thyroid and diabetes may also influence pregnancy loss. Anomalies in a mother’s blood clotting process are also one of the reasons for pregnancy loss.
• Environmental factors, occupational factors and stress do not seem to be related to pregnancy loss.

Testing:

• Karyotype analysis of both parents: The karyotyping is the process, which is done to detect structural or numerical anomalies in the chromosomes in the parents.
• Regular evaluation of the uterus and the uterine cavity with advanced methods like ultrasound, saline ultrasound, hysteroscopy (to look inside the uterus), hysterosalpingogram X-ray, MRI.
• Genetic analysis of the parents: In certain cases, both of the parents are the carrier of some genetic mutations which gets exacerbated in their offspring, that might result in certain structural or functional defect that leads to incomplete embryo formation.

Treatment:

• People having chromosomal aberration are often referred for genetic counselling.
• In case of a uterine abnormality, surgery is advised depending on the defect.
• If antiphospholipid syndrome has been diagnosed, that medications that are known to reduce blood pressure are usually given.
• If thyroid dysfunction or diabetes are diagnosed, particular medications should be prescribed.

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