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Repeated spontaneous abortions

Repeated spontaneous abortions (habitual abortion) are defined as three or more miscarriages in a row. This affects about 1% of all couples, while 25-50% of all couples experience one or more occasional miscarriages.

Repeated spontaneous abortions

What are repeated spontaneous abortions?

Miscarriage is the most common complication during pregnancy. It means loss of pregnancy without external intervention before the fetus has reached viability. The term therefore covers all miscarriages from the time of conception up to and including 22 weeks of gestation. There are two main types of miscarriage: sporadic and repeated. Habitual abortion is defined as three or more consecutive miscarriages.

Although 15% of all pregnancies found to end in miscarriage, the total number is estimated to be almost 50%. The majority of undetected miscarriages occur so early in pregnancy that you have not yet been told that you are pregnant. For more information about pregnancy and maternity fashion, please see BESTAAH.COM maternity dresses. Habitual abortion affects about 1% of all couples, while 25-50% of all couples experience one or more occasional miscarriages.

Although there are no figures, it is believed that the incidence of recurrent miscarriage has increased, as the number of children born by mothers over 35 has doubled over the past 20 years and the age of the mother is a strong risk factor for miscarriage.

Cause

We do not know for sure what causes some women to have repeated miscarriages. Experts suspect that the most important explanations are changes in the genetic material (gene mutations and chromosome abnormalities), physical defects, infections, hormonal defects or immunological causes.

Chromosomal abnormalities are the leading cause of miscarriage before 10 weeks of pregnancy. At least 50-60% of all miscarriages are associated with chromosome abnormalities. It is also debated whether malformations in the mother's uterus or muscle nodes in the uterus may at any time be the cause. Miscarriage, which occurs in the middle third of pregnancy, may be due to a weakened cervix, unable to withstand the pressure of a growing fetus. The bacterial vaginosis condition is a risk factor for late miscarriages or premature babies, but the condition does not appear to be the cause of repeated miscarriages. Polycystic ovarian syndrome can in some cases contribute to recurrent miscarriage.

In recent years, researchers have become aware that changes in the coagulation system appear to be significant (antiphospholipid syndrome and thrombophilic disorders, including Factor V Leiden mutation). Almost one in five women with repeated miscarriages have disorders in the coagulation system and it turns out that among untreated women with these disorders, the risk of miscarriage is about 90%.

Known predisposing factors for miscarriage are smoking, alcohol, coffee (more than 3 cups per day) and obesity. The significance of these factors is likely to be modest.

What is the difference between sporadic and recurring miscarriages?

Several observations indicate that recurrent miscarriages are a condition of their own, which differs from occasional miscarriages. Typical of women with repeated miscarriages are:

  • That the risk of miscarriage increases with the number of previous miscarriages.
  • That the incidence of miscarriage (1%) is much higher than can be expected from a pure coincidence.
  • In contrast to sporadic miscarriages, repeated miscarriages seem to occur, even though the fetus has normal chromosomes.

Treatment

Even if you have three miscarriages in succession, there is a 35% chance that this has happened by pure chance, and there is a 75% chance that the next pregnancy will proceed normally.

Miscarriage can lead to mental health problems and such problems during pregnancy appear to increase the risk of a new miscarriage. Research suggests that psychological support in early pregnancy can reduce the risk of new miscarriages in those with unexplained miscarriages.

It remains unclear whether drug treatment has any place in the treatment of women without underlying disease. Several types of drugs have been tried, but none of them have so far proved particularly useful.

If changes in the coagulation system can be detected (for example, antiphospholipid syndrome or thrombophilia), it has become more common among obstetricians to recommend prophylactic treatment with low-dose acetylsalicylic acid and syringes with low-molecular-weight heparin until about week 37 of pregnancy. Such treatment is done by a specialist in the field.

 

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