Repetitive Miscarriages

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When a patient has three or more consecutive miscarriages, the term repetitive miscarriage is used.

Though some physicians don't recommend testing until three losses, most couples don't want to wait that long to find the issue and address the cause. Dr. Douglas will usually start trying to determine if a treatable condition exists after the second loss. If the loss occurs in the second trimester, a work up should be schedule after the first miscarriage.

Several factors can contribute repetitive miscarriages, including:

• Anatomic abnormalities such as uterine septums or scarring in the uterus
• Hormonal abnormalities related to estrogen, progesterone or thyroid hormone
• Genetic abnormalities such as translocations that can be from either the husband or wife
• Autoimmune disorders such as antiphospholipid antibodies, which can attack the placenta and cause clot off blood supply to the fetus
• Other clotting abnormalities
• Infections in the lining of the uterus
• Abnormal uterine lining
• Unexplained causes

To determine the cause of recurrent miscarriages, Dr. Douglas will recommend several tests:

• An HSG, x-ray or saline histogram to look for abnormalities in the uterus
• Hormone testing of estrogen, progesterone and thyroid hormone
• Testing of antiphospholipid antibodies and other clotting abnormalities also need to be done.
• Chromosome testing of both partners for certain genetic abnormalities
• Testing or treatment of a potential infection from ureaplasm or mycoplasma
• A sonogram to rule out fibroids and polyps and check that the lining of the uterus is thick enough to support a pregnancy

Once Dr. Douglas completes testing and can identify the reason for multiple miscarriages, he can determine an effective treatment plan. Because recommended therapies depend on the cause of the miscarriages, treatment is not the same for every patient. Fortunately, a good percentage of couples with repetitive miscarriage can have a successful term pregnancy after proper treatment.
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