Repeat miscarriages are considered when a woman has had three or more miscarriages unintentionally. A miscarriage is one that occurs when the pregnancy ends unsuccessfully before 20 weeks gestation.
Repeat miscarriages are less frequent past 20 weeks gestation, when the conceptual term changes to fetal exsitus rather than miscarriage. Abortion and late fetal loss are two concepts that must be differentiated since the causes that motivate them as well as the treatments are also different.
Main causes of repeat miscarriages
Repeat miscarriages can be caused by:
- Problems in the chromosomes of the fetus: Chromosomes are structures in cells that contain thousands of genes, and chromosomal problems in chromosomes usually occur by chance. However, sometimes the mother or father also has a chromosomal problem and it is passed on genetically. This phenomenon may increase with age.
- Alterations in the shape of the uterus.
- Autoimmune diseases in the mother: in these cases there are immunological factors that imply that the body itself fights against healthy tissues instead of infections.
- Other medical pathologies in the mother such as diabetes, thyroid disease, blood clotting problems or hormonal problems.
In many cases, however, it is not known why repeat miscarriages occur.
What medical tests do women with repeat miscarriages need?
Screening tests for women with repeat miscarriages will include:
- Review with the patient her medical history, past pregnancies and menstrual periods.
- Complete gynecological examination.
- Clinical blood tests for immune system status, coagulation system and hormone levels. Thyroid disease or diabetes will also be ruled out.
- Gynecological ultrasound to check the uterus and ovaries.
- Sometimes a hysteroscopy may be indicated: a test to look inside your uterus through a thin tube with a camera and a light.
- Study of the parents’ chromosomes.
Other tests may also be needed on a case-by-case basis.
Can a woman with repeated miscarriages eventually have children?
If the cause of repeat miscarriages is found and can be treated, the chance of a successful pregnancy will be greatly increased.
For example, problems in the uterus can sometimes be treated with surgery; as well as certain medical problems that can be treated with medication.
What medical follow-up will a woman with repeated miscarriages need?
Whenever a woman is aware of her pregnancy status, she should consult her gynecologist for regular follow-up care so that she can be monitored for possible risks and/or diseases that may arise. A good control of the pregnancy will minimize problems that could put the mother’s health at risk.