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What is Recurrent Miscarriage?

Recurrent miscarriage means having three or more pregnancy losses before 20 weeks of pregnancy. Because having miscarriages can be very distressing, Valentine Akande would consider two miscarriages in a row as “recurrent” in certain circumstances.

What Causes Recurrent Miscarriage?

Risk factors for miscarriage:

  • Being older i.e. over 35 years
  • Being overweight, BMI > 30
  • Smoking, alcohol and taking drugs
  • Family history of pregnancy losses
  • Non steroidals e.g. Ibuprofen

Abnormalities of the womb:

  • Fibroids
  • Uterine septum
  • Adhesions
  • Cervical incompetence
  • Inflammation of the womb lining

Clotting problems:

  • Phospholipid antibody syndrome
  • Thrombophlias (sticky blood)

Abnormal Chromosomes:

  • Balanced translocations (abnormality with parent)
  • Aneuploidy (abnormality with fetus)

Hormonal problems:

  • Thyroid disorders
  • PCOS (if overweight)
  • Poorly controlled diabetes

Immune problems:

  • Auto antibodies
  • Increased natural killer (NK) cells in womb lining
  • Anti nuclear antibodies

Tests Done for Recurrent miscarriage?

Valentine Akande will take a detailed medical and family history and request some of the following tests if appropriate:

  • Pelvic ultrasound scan
  • Chromosome analysis – karyotype
  • Hysteroscopy
  • Anticardiolipin antibody
  • lupus anticoagulant,
  • Thrombophilia screen
  • TSH & Thyroid antibodies
  • Autoimmune profile
  • Hormone tests – FSH/ LH/ AMH
  • Endometrial NK cell testing – CD56

Treatment for Recurrent Miscarriage?

This will depend on your history and the test results and could include the following:

  • Early pregnancy monitoring by Ultrasound scans
  • Progesterone
  • High dose folic acid
  • Aspirin
  • Prednisolone
  • Thyroxine
  • Heparin or Clexane
  • Antibiotics
  • Vitamin supplements
  • Metformin