Multiple miscarriages: The most basic explanations

This is an automatically translated article.

The article is expertly consulted by Master, Doctor Le Nhat Nguyen - Obstetrician-Gynecology Specialist - Vinmec Danang International General Hospital. Doctor has more than 20 years of experience in the field of Obstetrics and Gynecology.
Miscarriage is always a fear for couples who are preparing to become parents, and an obsession, even psychological torment for mothers who have had a miscarriage. Some of the factors that increase the risk of miscarriage are genetic, anatomical, and immunological.

1. What are multiple miscarriages?

You are considered to have had multiple miscarriages if it occurs 2 or more times. The percentage of women at risk of multiple miscarriages is quite small, about 1%. According to the advice of doctors, after the 3rd miscarriage in a row, you should conduct a thorough examination and perform general tests to find out the cause and appropriate treatment.

2. Common Causes of Miscarriage

Most miscarriages (about 60%) occur randomly, when the embryo receives an abnormal number of chromosomes during fertilization. This happens completely by chance and is not related to a medical condition or a disease. However, if the mother becomes pregnant at an older age, she is at greater risk of this condition.
2.1. There are genetic problems There won't be any outward signs or symptoms in some couples with multiple miscarriages. But if their egg or sperm carry an abnormal chromosome, the translocation (cell division) causes the zygote to receive too many or too few chromosomes during fertilization. And this will lead to miscarriage.

2.2. Abnormalities in the reproductive organs Anatomically, some congenital uterine problems are associated with repeated miscarriages including:
Separation of uterus : Among a variety of abnormal muscle abnormalities In this regard, a septate uterus is the most common cause of miscarriage. Instead of taking the form of an empty cavity like in healthy women, the uterus is now divided into two parts by a tissue wall. Asherman's syndrome: The formation of scar tissue in the uterus, also known as Asherman's Syndrome, which results in a narrow uterine cavity or the front and back of the uterus sticking together, which can cause recurrent miscarriages, even miscarriages. even before the woman knows she is pregnant. Abnormal cell growth: Benign (non-cancerous) fibroids and uterine polyps are another reason why women have repeated miscarriages. 2.3. Some other diseases Some diseases can increase the risk of multiple miscarriages such as:
Antiphospholipid syndrome (APS): is an autoimmune disorder in which the patient's immune system mistakenly and creates antibodies to certain substances involved in normal blood clotting. Many studies show that APS is associated with multiple miscarriages and fetal death. Diabetes: Another disease that can lead to miscarriage is diabetes, when blood glucose levels are high. If your diabetes is poorly controlled, your risk of miscarriage is higher. Polycystic ovaries also increase the risk of miscarriage.

3. Diagnose the cause

In about 50-75% of cases, the exact cause of repeated miscarriages cannot be found, but some abnormalities can still be diagnosed, if any.
Usually, to help find the cause of repeated miscarriages, doctors will ask you about your medical history and past pregnancies. A general surgical exam, including a pelvic exam, may also be done. In addition, blood tests to help detect problems with the immune system or genetic causes of repeated miscarriages should also be performed. Finally, ultrasound scans the image to see if you are experiencing uterine abnormalities related to miscarriage.

4. Treatment when the cause is identified

You can rest assured that about 65% of women who have had multiple miscarriages with no known cause have a good chance of succeeding in the next pregnancy.

On the contrary, if the cause of recurrent miscarriage has been identified, the doctor will choose the correct treatment for each disease to increase your chances of a successful pregnancy.
Chromosomal translocations: Get professional genetic counseling if you have a chromosomal translocation disorder. In vitro fertilization combined with special genetic testing, also known as preimplantation genetic diagnosis, will help to select unaffected embryos. Problems with the reproductive organs: Surgery to correct uterine abnormalities, such as removal of the septum in the uterus, can help increase the chances of a successful pregnancy. Antiphospholipid syndrome (excessive blood clots in the arteries and veins, blocking circulation): Doctors will prescribe medications that prevent blood clots, such as heparin, sometimes combined with low-dose aspirin in during pregnancy and for a few weeks afterward for women with this immune condition. Negative psychological effects are inevitable after a miscarriage, especially when there are repeated miscarriages, family happiness is at risk of breakdown. If you are not stable and comfortable mentally, physically resting after a miscarriage, the chances of women keeping a successful pregnancy will be less. To avoid falling into the above undesirable situation, in addition to changing your lifestyle when you know you are pregnant, doctors recommend that you do not skip pre-marital health checks or general tests before becoming pregnant. and regular pregnancy monitoring.

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Reference source: Acog.org.