Treatment For Recurrent Abortions

Recurrent pregnancy loss (RPL) (also referred to as recurrent miscarriage or habitual abortion) is the spontaneous loss of at least 2 consecutive pregnancies in a nulliparous woman, or loss of 3 consecutive pregnancies in a woman who has experienced a live birth (prior to 20 weeks from the last menstrual period). The term Spontaneous is defined as “without medical or mechanical means to terminate a pregnancy before the foetus is sufficiently developed to survive.” Epidemiologic studies have revealed that almost 20-25% of all recognized pregnancies end in miscarriage, less than 5% of women will experience two consecutive miscarriages and only 1% experience three or more.

Above and beyond the fact being a medical issue, it is also a serious, disturbing psychological condition.  This condition can make the woman miserable and awfully drained of hope. Women report not only a mournful process, with all its stages, but a collision on feelings of guilt and doubts. Their self-esteem can become shoddier with each loss. However, the good news is that under medical supervision, most women who have experienced recurrent abortions go on to become happy mothers.

What Causes Recurrent Miscarriages?

Increasing paternal age or maternal age, chromosomal abnormalities and multiparty or repeated pregnancies are the main risk factors of recurrent abortions. Several factors are held responsible for the recurrent miscarriages. But sometimes the cause is unknown as well. As sad as it is, one miscarriage does increase the chances of a subsequent miscarriage. Please keep in mind that these causes are not common.

Uterine conditions: About 3 in 100 females worldwide are born with a defect in the shape, size or structure of the uterus.  A septate uterus is the most common congenital uterine abnormality. Uterus is divided into two internally by a band of muscle or tissue called septum and can cause repeated miscarriages.

Cervical conditions: Cervical conditions such as weak cervix or cervical incompetence is the next common condition which means that a woman's cervix begins to dilate too early in pregnancy. Cervical incompetence can lead to miscarriages or preterm deliveries

Genetic or chromosomal disorders: Chromosomal disorders are also responsible for repetitive abortions.  

• Translocations: Robertsonian translocation effects acrocentric chromosomes in either of the partners can cause infertility or recurrent abortions.
• Aneuploidy: It's estimated that aneuploidies are the most common cause of miscarriages before the tenth week of pregnancy. This is a condition in which a cell has an abnormal number of chromosomes.

Endocrine disorders: hyperthyroidism and Hypothyroidism can result in untimely loss of pregnancy or recurrent miscarriages. Uncontrolled Type 1 and Type 2 diabetes can lead to miscarriages. Anti-thyroid antibodies (antibody directed against the thyroid gland) are also concerned with recurrent miscarriages

Thrombophilia: Thrombophilia (also known as hypercoagulability) is an inherited or acquired disorder that increases a person's risk of developing thrombosis (abnormal “blood clotting”).

Immune factors: Poorer maternal immune tolerance for the foetus is another factor causing abortion

Antiphospholipid syndrome(APS): This is an autoimmune disease and this syndrome causes tiny blood clots to obstruct the blood supply to the placenta. 

Ovarian factors: The vulnerability to miscarriage increases with an increasing age due to diminished ovarian reserve (DOR) and the poor quality of maternal eggs they become vulnerable to miscarriages.  It's not unusual to be concerned about your pregnancy if you have polycystic ovary syndrome (PCOS). 

Lifestyle factors: smoking or consuming alcohol, Excessive exposure to toxins can also cause recurrent miscarriages

Infection: Many infections such as listeriosis, Salmonella infections, ureaplasma, toxoplasmosis and viral infections (measles, rubella, herpes, cytomegalovirus) etc. are also among the notorious causes of miscarriages.

Treatment for Recurrent Abortions 

Counselling:  The primary objective of Abortion counselling is to empower the woman.  They will be advised to curb rigorous activities and exercises.   Many women have higher levels of anxiety and depression for up to a year after a miscarriage and some even experience post-traumatic stress disorder (PTSD).

Treatment for recurrent abortion is suggested according to the cause determined.

Blood-thinning medicines:

Women with clotting or autoimmune (thrombophilia) disorders may be treated with low-dose aspirin and heparin. During pregnancy, these medicines can be taken to lower the risk of miscarriage. Always consult with your gynecologist before using these medicines because they increase the chances of severe bleeding problems (such as ulcers).

Endocrine problems: 

The abnormal blood sugar levels, an over- or underactive thyroid gland, or high levels of the hormone prolactin can improve the chances of having a healthy, full-term pregnancy.

Genetic screening:

When one or both the parents has a suspected rearrangement (translocation) of their chromosomes their blood can be studied (karyotyped) to confirm if they have a translocation. The doctor might recommend genetic counselling if a chromosomal aberration is found. Despite the fact that many couples with translocations can conceive a healthy pregnancy naturally, your doctor may also suggest fertility treatments (depending on your individual needs), such as in vitro fertilization (IVF). During IVF, they can be screened (preimplantation genetic screening) which allows embryos without translocations to be selected to increase the chance of a healthy pregnancy.

Lifestyle choices: Quitting smoking and illicit drug use will tremendously lower the risk for miscarriage. Limiting caffeine and alcohol intake may also help. Obesity has been linked with increased risk of miscarriage, so healthy weight loss might also help pregnancy outcomes. There is no proof clinically that anxiety, stress or depression causes RPL. 

Surgery: surgery is recommended for uterine abnormalities (like septum), some fibroids (benign tumors), endometriosis and scar tissue.  Hysteroscopic metroplasty is a type of reconstructive surgery which enables a doctor to correct an erratically shaped uterus. Laparoscopy is used to get rid of fibroids, endometrial growths and pelvic adhesions, which can lead to miscarriage.

Smile Baby IVF is a renowned infertility treatment centre at lingarajapuram, Bangalore known for providing affordable treatment for infertility and low cost IVF India. Dr. Mangala Devi K R is a practicing Obstetrician, Gynaecologist and Infertility specialist in Hennur, having above 11 years experience who can be consulted for hysterectomy, gynec issues, ivf treatment in Bangalore, infertility treatment, IUI,cesarian section, delivery, ART and Habitual abortions in India. For treatment for recurrent abortions in Bangalore,    Book appointment online or contact in phone with the Infertility specialist in Hennur, who provides quality infertility treatments in Karnataka.

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