- Habitual miscarriage - can and should be treated
About habitual miscarriage usually tell when a woman happens three or more miscarriages in a row, although the American Society for Reproductive Medicine recently gave it a violation of the new definition, according to which the habitual miscarriage can be diagnosed when two or more miscarriages in a row.
Abortion is called a spontaneous abortion occurring before 20 weeks of pregnancy (if labor has begun on the 20-37 week, talking about premature birth, whether the child is born alive or not).
The causes of most cases of recurrent miscarriage are genetic abnormalities. One or the other may be an anomaly in the egg, sperm or embryo. Approximately 12-15% of confirmed pregnancies end in miscarriage. Moreover, experts believe that at least 30-60% of all pregnancies (in the case of unconfirmed) also completed miscarriage during the first 12 weeks of gestation. Approximately 50% of women do not even know that was pregnant - the symptoms of miscarriage, they may take, for example, unusually heavy menstrual bleeding (this is, of course, does not mean that heavy menstruation is always a sign of miscarriage in early pregnancy).
One of the factors that increase the likelihood of habitual navynashivaniya, doctors believe that women in developed countries are now planning to give birth in an increasingly older age. This is one of the reasons for reducing the quality of the eggs, which can lead to a variety of genetic abnormalities. Sometimes the mother or father (or both), there are minor defects in the genes that may be more pronounced in the unborn child, leading to miscarriage.
Various abnormalities associated with the uterus can also cause recurrent miscarriage. For example, a miscarriage may result from disturbances in blood flow to the developing fetus or the inflammatory process in the uterus. Some women from the birth of an abnormal shape of the uterus, in other certain irregularities in its structure appear over time - it can also lead to recurrent miscarriage.
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And workplace rights, apparently not connected with recurrent pregnancy loss.
If a woman has revealed habitual miscarriage, the doctor, first of all conduct a thorough study of her personal and family history (as well as the history of her partner), and then assigns a number of analyzes. For example, it can be analyzed karyotype, whose task is to identify the parents of anomalies that can be transmitted to their potential child and cause miscarriages. Since karyotype abnormalities are relatively rare, analyze it is not necessary; it may be necessary only in those cases where they are excluded other more common disorders that can cause miscarriage.
During the diagnosis is often studied the state of the uterus. This can be done using ultrasound, hysterosalpingography
Hysterosalpingography - effective examination of the uterus
, Magnetic resonance imaging and / or hysteroscopy
Hysteroscopy - examination of the uterus inside
. As a general rule, primarily carried ultrasound (US). It provides information on the form and the presence of uterine fibroids in it (benign tumors). With hysterosalpingography can estimate not only the state of the uterus and fallopian tubes (e.g., to determine their permeability).
Hysteroscopy - a procedure in which the uterus through the cervix administered thin tube with a camera, which can be used to inspect the inside of the uterine wall. With this technology it is also possible to remove polyps, fibroid tumors, and scar tissue. Magnetic resonance imaging (MRI) is usually carried out to determine the exact location of the fibroids, as well as some forms of uterine anomalies.
In the process of diagnosis can also be carried out tests for antiphospholipid antibodies, especially in the anticardiolipin antibodies and lupus anticoagulant. These antibodies are associated with antiphospholipid syndrome, which can be one of the causes of recurrent miscarriage.
Checking women with recurrent pregnancy loss on hereditary thrombophilia is generally not recommended, since no studies have shown that medical treatment can significantly reduce the chance of blood clots in these patients. However, tests for blood clotting recommended for women who have a personal history of thrombosis combined with risk factors such as surgery, fractures or prolonged immobilization. Analyses are required and if a parent or blood siblings of the patient had serious disorders associated with blood clotting.
In many cases, patients with habitual miscarriage prescribed analyzes on hormones. For example, it can be carried out tests on thyroid hormones
Tests for thyroid hormones - screening for diseases
and prolactin - a hormone that is responsible for the production of breast milk. If the patient has an increased risk of developing diabetes or already have symptoms, tests conducted on diabetes - a disease can also lead to recurrent miscarriage.
A method for treating patients with recurrent pregnancy loss depends on the cause of this disorder, but whatever the outcome of the diagnosis probability of a healthy pregnancy in the future is quite large. In the absence of a serious anomaly it is 77%, in the presence of certain anomalies - 71%.
Patients whose karyotype analysis showed certain genetic abnormalities are often sent to genetic counseling. This allows you to better understand the nature of these variations and determine the probability of healthy and abnormal pregnancy in the future. Some women who have previously were detected habitual miscarriage may take prenatal examinations to detect possible genetic defects in the unborn child. It uses techniques such as amniocentesis and chorionic villus sampling.
Often, women with recurrent pregnancy loss require vitro fertilization with preimplantation genetic diagnosis (PGD). During the procedure, patients are removed from the ovaries of eggs that are fertilized in a test tube. Then the biopsy resulting from such fertilization the embryo and analyzed for genetic disorders. This avoids the transfer of embryos into the uterus, have certain developmental defects.
If it is determined that the habitual miscarriage associated with structural defects of the uterus may be carried out surgery to correct such defects. Patients diagnosed with antiphospholipid syndrome, may be assigned the administration of drugs that reduce the risk of blood clots. If during the diagnosis revealed violations of the thyroid gland or diabetes, is also assigned medication.
Approximately half of the patients with recurrent miscarriage to determine the causes of this disorder is not possible. In such cases may be assigned different treatment methods, including - in vitro fertilization, but universal guidelines for the treatment of these patients do not exist. Despite this, the chance of pregnancy and normal gestation in the future is high enough - it is more than 50%, even in the absence of medical intervention.