Evaluation and treatment of recurrent pregnancy loss
Recurrent loss of pregnancy (RPL) is characterized by two or more failed pregnancies that occur in a short time one of the other. Women with unexplained causes of miscarriage can make lifestyle changes to treat this problem. Numerous causes of this problem ensure the research and treatment.
What is the reason to evaluate recurrent pregnancy loss?
Recurrent pregnancy loss consists of a medical evaluation. Many couples also benefit from psychological support. The evaluation is carried out:
- Women of advanced age: adult material means a greater likelihood of abortion, usually due to chromosomal abnormalities of the embryo.
- Causes genetic and chromosome – pairs with chromosomal defects and those with chromosomal abnormalities of the embryo are at greater risk of miscarriage.
- People with metabolic abnormalities, women with poorly controlled diabetes and (PCOS) polycystic ovary syndrome tend to have more miscarriages.
- Women with hormonal abnormalities – this includes low progesterone levels, since this hormone is responsible for maintaining a thick Uterine lining to keep the embryo in its place.
- Antiphospholipid antibodies – these will cause the blood to clot when they must be thin.
- Women with thrombophilia – this congenital disease makes it blood clotting and increased fetal mortality during the last part of the pregnancy.
- Causes of male factor infertility, sperm defects can lead to recurrent miscarriages.
Is recurrent pregnancy loss frequent?
According to the society of reproductive medicine, approximately 3% of the women of reproductive age have RPL. In general, 20% of pregnancies end in spontaneous abortion associated with an unidentified cause.
What causes the RPL?
The most common cause for RPL is abnormal number of chromosomes in the egg. The transfer of a portion of genes from one chromosome to another is the chromosomal translocation, which occurs in about 4% of the cases. Other causes include:
- Congenital uterine malformations
- Uterine tumors (fibroids and polyps)
- Incompetent cervix (cervical dilatation without contractions)
- (STI) sexually transmitted infections
- Hormonal problems (due to dysfunction thyroid disease or pituitary)
- Abnormal blood clotting (phospholipids or antibody-related)
- Lack of protective antibodies (immunity anti-fetal)
What does the evaluation of recurrent pregnancy loss?
An evaluation of recurrent pregnancy loss requires a full work up. It's a medical history, physical exam, ultrasound, various blood tests and genetic screening. When a genetic component is suspected, couples often must undergo pre-implantation genetic diagnosis (PGD) before undergoing any technology of assisted reproductive technology (ART). In addition, a hystersalpingogram or Hysteroscopy is performed to evaluate the shape of the uterus.
How is the RPL?
Treatment of recurrent pregnancy loss depends on the underlying cause. Treatment options are:
- Donor eggs or donor sperm – these are used when PGD reveals a genetic defect or chromosomal abnormality.
- Anticoagulant management – this is done when the woman has a thrombophilia disorder or autoimmune problem.
- Outpatient surgery – this is used to correct uterine abnormalities and remove polyps or fibroids.
- Adjustment of life style, due to excessive consumption of alcohol or smoking can lead to RPL, advice is given on changes of lifestyle and habit. Also, weight control can improve the chances of a successful pregnancy.
- Low doses of aspirin – disorders of the Antiphospholipid Antibody, protein affects the developing fetus. This is often treated with a low dose of aspirin.
- Correction of hormonal problems, this implies tight glucose control for people with diabetes and administrator of the thyroid hormone for women with an underactive thyroid.
What risk factors increase the chances of recurrent pregnancy loss?
Certain situations or substances increases the risk of RPL. These components are:
- Alcohol consumption
- Advanced maternal age
- Use of illicit drugs
- High caffeine consumption
- Being overweight or underweight