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Recurrent miscarriages

Recurrent miscarriages  is a condition when a woman has 2 or more clinical pregnancy losses (miscarriages) before the pregnancies reach 20 weeks.  In most cases, a pregnancy can
be seen with ultrasound as early as 5-6 weeks’ gestational age (or 1-2 weeks after a missed period). A “biochemical pregnancy” loss is one that has been detected only by urine or blood hormone
testing before disappearing. Biochemical losses are not usually included in making a recurrent miscarriages diagnosis.

Causes

Genetic
Many early miscarriages (the ones that happen in the first 3 months of pregnancy) are due to genetic abnormalities in the embryo or fetus. Normally, there are 46 chromosomes that contain the genes
for normal development. Many early miscarriages happen because the fetus has an extra chromosome or one is missing. For example, babies with Down syndrome have 47 chromosomes. Chromosome
abnormalities occur for no known reason in up to 60% of first-trimester miscarriages. Genetic abnormalities typically do not allow development into a healthy baby. As women age, the miscarriage
risk due to these genetic abnormalities increases— from 10%-15% in women younger than 35 years old to more than 50% in women over 40 years old.

Anatomic
A problem with the shape of a woman’s uterus might be a cause for pregnancy loss. Having a band of tissue inside the uterus, called a septum, can make
the inside of the uterus too small. Women born with a septum may have more frequent miscarriages. Fibroids, benign muscle tumors of the uterus, are
common. These can lead to miscarriages if they grow into or near the uterine cavity.

Lifestyle/Environmental
Smoking increases the risk for recurrent miscarriages.  Being overweight has been linked with recurrent miscarriages as well as other pregnancy complications. Excessive alcohol or caffeine intake might be linked
with recurrent miscarriages.

Medical
Untreated medical conditions, such as thyroid disease or diabetes, can increase the risk for miscarriage. Abnormalities of the immune system or blood-clotting system (thrombophilia) can also
cause recurrent miscarriages.
Unexplained
In over half of recurrent miscarriages cases, doctors cannot find the cause for losses. However, many of these may be due to genetic abnormalities.

Investigation
Blood tests can show if a woman has certain medical, immune, or blood-clotting conditions that might cause recurrent miscarriages. The chromosomes of women and their male partners can be studied using a
special blood test called a “karyotype.” Some healthy people have differences in the way their chromosomes are arranged. This can increase their risk for genetically imbalanced pregnancy losses.  ultrasound (sonohysterogram) can show if a woman has a problem with the shape of her uterus. If available, the tissue from a miscarriage can be tested for genetic abnormalities.

Treatment
With certain conditions, medical or surgical treatment can lower a woman’s risk for future miscarriage. For more information please make an appointment with Dr Barak for proper discussion regarding your recurrent miscarriages