Recurrent Miscarriage - What Causes It?

Hello! I am Dr Renu Mathur Keshan. I will today be talking about recurrent pregnancy loss. I am a gynaecologist so that is my topic. It’s a very traumatic condition- Recurrent Pregnancy Loss. It affects about 2 to 5% of all married couples. And 2 or more abortions in less than 20 weeks of gestation that is less than 5 months is called a recurrent pregnancy loss. It is becoming very common nowadays as marriages are late so people are under stress and they want to have a baby soon that makes them more stressed out. But the main causes actually are uterine abnormalities. If the shape of the uterus is not okay which is a genetic formative condition – not much can be done about it on the patient side, that causes the pregnancy to get aborted at an early age.

Another common cause is autoimmune diseases which are called antiphospholipid diseases. Metabolic & hormonal diseases which are uncontrolled can also cause this problem. And the 4th common cause is Genetic formations which are when there is something wrong in the formation of the baby. This is very troublesome for the patient as well as the doctor because the patient is already stressed out. The lifestyle is bad nowadays that causes a problem, the patients are not getting enough rest, there is a tendency to be involved in junk foods & women are drinking and smoking – so all these things have to be changed. When a pregnancy is planned, ideally 2 to 3 months before, a lady should start taking folic acid and try to switch over to a healthy lifestyle which would include taking green vegetables & fruits, protein-rich diet, abstain from alcohol & smoking. A little bit of exercise would also help. Now once this happens the patient is very stressed out, this does not mean it's going to happen in the subsequent pregnancies also but care has to be taken. So now about the treatment modalities. If we are clearly able to demonstrate that there is a formation defect in the uterus which is not allowing the pregnancy to go on normally then surgical management is done to alter the condition of the uterus whether it is the shape, whether it is an extra membrane in between that can all be resolved surgically.

Then subsequent pregnancies will be successful. Hormone support is given if there is any hormone imbalance. Usually, progesterone is given. Then uncontrolled diabetes & uncontrolled hypothyroidism will be treated and control on the diseases will cause the pregnancy to be successful. For antiphospholipid syndrome which is an autoimmune disease, heparin is very successful in the treatment of that. But a lot of contribution is made by the patient side, reassurance from the doctor and the support of the family. Rest would be required, a healthy lifestyle is required. Now people will always ask what will we have a normal delivery? I think that is a very late stage to concern yourself with. Go ahead with a healthy pregnancy and then we can talk about it. I think that takes care of all about recurrent pregnancy losses, causes and its treatment. Thank you!