Recurrent Early Pregnancy Loss - How To Tackle It?
Recurrent pregnancy loss (RPL) is defined as a condition where the woman suffers three or more pregnancy losses consecutively and the miscarriages occur within 20 weeks from the last menstrual cycle of the women. This condition is fairly common in women. Some of the causes that may be responsible for this condition include genetic factors, uterine disorders, hypothyroidism, diabetes, anatomical or cervical conditions, endocrine-related disorders, auto-immune diseases, chronic endometritis, viral infection, ecological conditions, and antiphospholipid antibody syndrome (APS).
As part of the RPL diagnosis, transvaginal ultrasonography is suggested. If the woman is not pregnant, had two to three pregnancy losses in the past, and is being evaluated for recurrent pregnancy loss, we may also deem it suitable to conduct parental chromosome testing (karyotyping) of both the partners. Also, blood tests may also be carried out to determine blood sugar levels, thyroid-related problems, ovarian dysfunction, and thrombophilia.
When treating a woman for RPL, the need is to determine the cause of this condition. In cases of congenital thrombophilia and antiphospholipid syndrome, anticoagulants would be prescribed if the woman has suffered recurrent miscarriages. Several studies conducted in the past have shown that through a course of antibiotics, women suffering from chronic endometritis can enjoy a healthy pregnancy. In cases wherein the woman is found to have a karyotypic disorder, she is advised to undergo genetic counselling. During the sessions, the genetic specialist will have a discussion on the type of genetic disorder and the possibility of future pregnancies.
Some couples may also opt for prenatal genetic studies for analyzing the genetic makeup of the fetus. In this procedure, chorionic virus sampling and amniocentesis may be carried out. In cases of chromosomal conditions, when treatment is not available, the in vitro fertilization (IVF) with preimplantation genetic diagnosis (PGD) procedure may be advised. As a part of this treatment, the woman is given shots over a period of some days for eggs to grow in her ovaries. Then, the eggs are obtained through a minor surgery and sperm are injected into them to enable the embryos to grow. Thereafter, a single cell of the embryo is subjected to biopsy and the genetic composition is examined. This helps to prevent the transfer of an affected embryo. In cases of uterine abnormality, then surgery may be conducted as a part of the treatment.
In cases of thyroid-related issues or diabetes, medicines for treating the respective conditions are prescribed. However, if the patient has antiphospholipid syndrome, they are given drugs to prevent the development of blood clots.
The condition of women who has a history of recurrent pregnancy loss must be monitored closely. Even if they are given proper treatment, the chances of future pregnancy loss cannot be ruled out completely. After each pregnancy loss, the woman may suffer from psychological trauma and she may harbor doubts about her ability to conceive as well. In such cases, they require counselling for helping them in overcoming their grief. Also, recurrent miscarriages can result in women suffering from coronary heart disease, cardiovascular problems, and ovarian cancer at a later stage. During their later pregnancies, they run the risk of having preeclampsia as well.
Unexplained RPL: In cases of unexplained RPL, there are no treatments available. The afflicted groups are given counselling. By doing so, there is around 50 to 60 percent probability of them delivering in their subsequent pregnancy. However, with each pregnancy loss, the woman’s chances of conceiving diminish. Aspirin is not known to be effective in preventing recurrent miscarriages in women. Also, immunotherapy does not meet the desired results. Currently, the drug NT100 is under scrutiny for improving the chances of conception in women with unexplained recurrent pregnancy losses.
+1.svg)
