Recurrent Miscarriage

What is a miscarriage?

Miscarriage is the spontaneous loss of pregnancy before the 20th week and is one of the most common complications of pregnancy. Two or more consecutive pregnancy losses is termed as recurrent miscarriage.

What are the causes of miscarriage?

In 50% of cases, the cause of miscarriage is not known.

Known causes of miscarriage include:

• lifestyle risk factors, such as smoking and excessive alcohol use
• genetic abnormality in the embryo, egg or sperm
• abnormalities in the uterus or womb, such as fibroids or polyps
• disorders of clotting
• disorders of immunity
• infections, such as bacterial infections in the vagina
• hormone disorders, such as thyroid disorders, diabetes, polycystic ovarian syndrome
• sperm factor, such as elevated sperm DNA damage

The following are factors that could increase risk of recurrent miscarriage:

• being above the age of 35
• being overweight or underweight
• previous pregnancy loss

How is recurrent miscarriage diagnosed?

Generally, I start by taking a thorough history and examination of the patients. Then, I often order a series of tests to determine the cause of recurrent miscarriage.

How is recurrent miscarriage treated?

Treatment for patients with recurrent pregnancy loss is based on the cause of the miscarriage.

If you have a genetic cause, you will be recommended genetic counselling, where you are counselled about the genetic abnormality and the possibility of having a normal pregnancy in the future. In cases of uterine abnormality, you may be recommended for surgery.

Medications may be prescribed to treat miscarriages related to diabetes, thyroid or hormonal problems.

Should an obvious cause not be found, I can provide supportive therapy to help you achieve an ongoing pregnancy.