Habitual miscarriage – causes, diagnosis and treatment
Sometimes the cherished happiness of becoming parents can be overshadowed by the diagnosis in the medical record – “habitual miscarriage”. Some women, desperate in such a situation, rush to put a cross on motherhood. However, “habitual miscarriage” is not equal to “infertility.” Therefore, first we need to figure out what this pathology is and how you can help the couple in this situation to become happy parents of a healthy baby. Details – in the material.So, the pregnancy has come, you are counting the weeks waiting for happiness, but happy waiting is interrupted by a miscarriage. And if the miscarriage is not the first, and the earlier pregnancies ended the same way, then here it is worth talking about the habitual miscarriage. The habitual miscarriage in the international classification of diseases is defined as two or more clinically documented pregnancy losses in terms of up to 20 weeks.
In such a situation, future parents are encouraged to seek help from specialists if:
the normal karyotype of the abortus was confirmed – that is, the embryo has a full set of chromosomes,
the couple has no earlier pregnancies;
The age of potential parents exceeds 35 years.
Among the causes distinguish genetic, anatomical, endocrine, infectious, thrombophilic, immunological, idiopathic (obscure) factors. However, it should be noted that the influence of certain factors is different with an accidental and repeated abortion.
With sporadic, or accidental, miscarriages, the effect of damaging factors is transient, it does not violate the reproductive function of the woman in the future. And the next pregnancy may well complete safely. In the structure of sporadic early miscarriages, one-third of pregnancies are interrupted for up to 8 weeks of anembrionic type (the absence of an embryo in the fetal egg). And this is not a reason for despair, but rather a reason for carrying out additional examinations – on the subject of existing pathologies, about which, perhaps, before the onset of pregnancy, a woman may not know.
Factors associated with early pregnancy loss
There are several factors affecting abortion up to 20 weeks. We distinguish the main ones:
Late age of mother (over 35 years)
Excessive use of caffeine (more than 100 mg of caffeine per day
Smoking (more than 10 cigarettes per day)
Obesity (<30 kg / m2)
Toxins and occupational hazards
Thus, if a woman can not give up bad habits, smokes, adding to a number of harmful factors alcohol, drinking a lot of strong coffee a day, does not monitor the correct diet and level of physical activity, she risks having future problems with miscarriage decides to become a mother.
Experts also recommend that when planning a pregnancy to give up bad habits and establish a healthy diet for at least a year before planning a pregnancy. Compliance with all recommendations of the doctor will allow you to avoid negative factors and increase the chances of a successful completion of pregnancy.
Examination of women with habitual miscarriage
– When conducting a comprehensive survey of spouses for habitual miscarriage, the first task of a specialist is to assess congenital factors predisposing to the development of high-risk thrombophilia.
– A blood test of spouses for compatibility with the HLA Class II system is also being conducted. We will explain a little. Immune mechanisms are involved in the development of recurrent miscarriage. Each person is unique in the set of HLA-determinants (tissue compatibility system). For the normal course of pregnancy, an important factor is the maximum difference between parents in the histocompatibility analysis. If this indicator is normal, then other risk factors are assessed.
– During the examination, a blood test is also assigned for the diagnosis of antiphospholipid syndrome (APS), a test for lupus anticoagulant (BA). Antiphospholipid antibodies have a direct damaging effect on the ovum with a further development of spontaneous abortion. The complex for the diagnosis of APS includes an assessment of the content of antibodies to cardiolipin, annexin, B2-glycoprotein, prothrombin, phosphatidylserine, a positive test for lupus anticoagulant.
– Spouse karyotyping is a study of the chromosome set of a person, which allows to identify deviations in the structure and number of chromosomes. The examination is carried out by light microscopy, the material for the study is venous blood. Normally, the human karyotype consists of 46 chromosomes. This survey helps to identify chromosome abnormalities, probably not affecting human health, but important for planning pregnancy and for the health of the unborn child.