Miscarriages: What causes recurring miscarriages?

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Pregnancy can be a stressful period and even worse is miscarriages that occur one after the other.

Dr. Pratibha Singal, an Obstetrician and Gynecologologist, Cloudnine Hospital says that there are women who have baseline hypertension and it is important to correct it before trying to get pregnant.

When a woman undergoes recurrent miscarriages, she is advised to seek urgent specialist attention to determine the exact cause.

Medscape says most spontaneous miscarriages are caused by an abnormal (aneuploid) karyotype of the embryo.

At least 50% of all first-trimester spontaneous abortions (SABs) are cytogenetically abnormal.

Major causes of recurrent pregnancy losses, according to Dr Singhal are:

Uterine anomalies

This is known to be the most common cause of pregnancy loss. There could be defects in the formation of the uterus that often goes undiagnosed till a woman has had at least two recurrent miscarriages.

APLA Syndrome

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Antiphospholipid syndrome (APLA) is an autoimmune state which causes blood clots to form with arteries, veins and organs, and requires timely treatment.

Cervical Insufficiency

This is where the cervix is weak and unable to hold the pregnancy; as a result, the foetus aborts on its own between 14 to 20 weeks. Cervical insufficiency can be genetic in some cases or from a previous surgical procedure.

Other causes are hormonal and metabolic diseases, uterine infections, malnutrition, weight issues, severe kidney or heart diseases,diabetes and cytogenetic diseases (involving tissues, blood, bone marrow).

“Less common causes are stressful conditions, may be at work or may be at home,” said the doctor.

Precautions to avoid recurrent miscarriages are as follows:

Do not delay the first pregnancy too much. The miscarriage rate among pregnant women above the age of 35 is 25%, which rises to about 51 %for women above the age of 40.

If there is any suspicion of APLA syndrome, it should be investigated and treated at the earliest.

Consumption of alcohol and coffee as well as smoking are frequently associated with recurrent miscarriages. So, these should ideally be given up before planning pregnancy.

Polyps and fibroids, if found in the uterus, should be surgically corrected and in case of uterine anomalies, the necessary corrections should be done before going ahead with the pregnancy.

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