The pain of losing an unborn child is a traumatic period for a couple, especially to a would-be first-time mother. Miscarriage and other forms of pregnancy loss can bring out a lot of questions that need to be answered. Many couples take it upon themselves to look for answers as to why the miscarriage happened. Others also focus on getting information about how the pregnancy loss could have been avoided.
Miscarriage is almost always not anybody's fault. In some cases, pregnancy loss is already a predetermined outcome from the start of conception. While there may not be any logical explanations at hand to explain why miscarriages happen, the medical community has been able to recognize a few known causes of miscarriage.
One-time miscarriage, also called sporadic pregnancy loss, is usually caused by chromosomal abnormalities during the development of the fetus. Doctors usually assume this as the default explanation for first time miscarriages due to the fact that most couples go on to have a normal pregnancy after one miscarriage.
Chromosomal abnormalities such as extra chromosomes or missing genes may cause the baby to stop developing and eventually lead to a miscarriage. After the first miscarriage, most medical professionals do not conduct testing for the cause of miscarriage since chromosomal flaws are usually random, one-time events. While miscarriage due to chromosomal flaws may occur to any woman at any age, those who are 35 years old and above are at highest risk.
When a miscarriage happens two times in a row, it is unlikely to be caused by random chromosomal errors. Usually, doctors will conduct a process of testing for recurrent miscarriage after a second case of miscarriage. In this case, chances are higher that the woman may have a detectable problem that causes the pregnancy loss.
In about 50% of the cases of recurrent miscarriages, doctors find a cause for recurrent miscarriages and then the woman is given treatment in anticipation of her next pregnancy. However, the other 50% may still not reveal any cause at all. In the same way, a woman may still get pregnant again even with two unexplained miscarriages, and still have greater chances of a normal pregnancy than another miscarriage.
Generally, causes of recurrent miscarriages are usually much more controversial compared to that of single miscarriages. Some of the most commonly recognized causes of recurrent miscarriages are:
lAbnormality in the structure of the uterus;
lBlood clotting disorders, such as antiphospholipid syndrome; and
lCertain chromosomal conditions, such as balanced translocation.
According to experts, low progesterone and other hormonal imbalances may lead to recurrent miscarriages. Although treatment with progesterone supplements is fairly common after one or two pregnancy losses, however, not all medical practitioners agree on the practice. Others believe that malfunction in the immune system, such as high levels of natural killer cells, may be the culprit.
Miscarriage after the 20th week are called stillbirths. Too-early births, on the other hand, are called preterm labors. Both preterm labors and stillbirths usually have different causes from that of earlier miscarriages, although chromosomal errors in the baby can also cause stillbirths. The most common causes of stillbirths and preterm labors are cervical insufficiency, problems in the placenta, and preterm labor due to medical issues in the mother.
At any rate, women are advised to seek out emotional support from family and friends when miscarriage occurs. Dealing with the emotional aftermath of miscarriage can be easily managed with the help of counseling.
Recurrent pregnancy loss exacts a devastating emotional toll on patients' lives. Each miscarriage brings with it a profound sense of loss and frustration. While hormonal, uterine, immune system, and chromosomal abnormalities are widely accepted as possible causes of repeat miscarriages, the latest studies point to a new area of investigation - inherited blood clotting factors.
When a patient has a tendency to form blood clots, the condition is called thrombophilia. Thrombophilia can be a life-threatening event if the clots restrict blood flow. Thrombophilia can be an inherited disorder, but can also be caused by external events such as surgery, obesity, pregnancy, use of oral contraceptives, antiphospholipid syndrome, or long periods of immobility. Physicians may suspect thrombophilia when patients have a blocked blood vessel at a young age or have a strong family history of clotting disorders (such as stroke, pulmonary embolism, or deep vein thrombosis). However, some patients with thrombophilia do not experience any symptoms. Or if they do have symptoms, the condition often goes undiagnosed because the tendency to make clots is subtle. Recent research suggests a possible correlation between inherited thrombophilia and recurrent fetal loss. Genetic markers for these clotting factors include factor V Leiden mutation and prothrombin G20210A mutation. These two mutations are the most common causes of inherited thrombophilia. These markers, as well as several others that have also been associated with recurrent miscarriage, can be detected through simple blood tests (see recommended testing).
Recent research indicates that patients who experience recurrent miscarriage may have one or more of these markers for thrombophilia. One study found that 19% of miscarriage patients (15 of 80) carried the factor V Leiden mutation compared to 4% of controls. Other indicators of thrombophilia (prothrombin mutation, activated protein C resistance, and antithrombin III deficiency) are also more prevalent among women experiencing frequent miscarriages [1,2]. Several other recent studies have reached similar conclusions. While more research is needed, this is a promising new area of investigation.
Treatment regimens used at Georgia Reproductive Specialists to manage thrombophilia may include heparin or Lovenox (low molecular weight heparin) injections, and baby aspirin or metformin (for insulin resistant patients with elevated PAI-1). These treatments are designed to improve blood flow in the follicle, optimize egg quality, and improve pregnancy outcomes. All patients receiving treatment must be carefully monitored. Patients on heparin require monthly PTT, blood counts, and platelet levels. These patients should also consider dietary calcium supplementation.
Both Monch Bravante & Frederic Lampard are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.
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