Causes of Miscarriage.
Miscarriage or spontaneous abortion is the loss of a pregnancy before 24 weeks. Most take place in the first 12 weeks. They occur in 15 - 20% of all pregnancies. Recurrent miscarriage is where the woman has three or more miscarriages in a row.
Causes of Miscarriage
Often the reason for miscarrying is not known but sometimes a definite cause can be found. When there has been more than one miscarriage each may have had a different cause.
Miscarriage can be caused by any of the following:
- Hormone imbalance - Progesterone is a hormone which prepares the lining of the womb for a pregnancy. If the egg is not fertilised the lining is shed in menstruation.
If a pregnancy occurs, progesterone, together with other hormones, continues to maintain the lining and keep the pregnancy secure.
If there are low levels of progesterone in early pregnancy a miscarriage can occur.
- Illness in the mother - Certain illnesses or disorders have been linked to a greater risk of miscarriage including: endometriosis or infection in the womb; autoimmune conditions such as Systemic Lupus Erythematosis; heart disease or severe kidney disease; uncontrolled diabetes or thyroid disease.
- Immune disorders - Our immune system forms antibodies to destroy foreign substances such as disease in our bodies. Occasionally in women with a history of recurrent miscarriages her body sees the baby as a foreign substance and attacks it.
- Abnormalities of the uterus - Uterine abnormalities include: defects present from birth, eg where the uterus is divided into two sections; fibroids, which are non-cancerous growths of uterine muscle tissue; an incompetent cervix, which opens too early in the pregnancy without any signs of labour.
- Environmental and lifestyle factors - These include: smoking or heavy use of alcohol or chemical substances; exposure to radiation or toxic substances.
- Chromosomal problems of the unborn child - These usually happen by chance. There is an increased risk associated with the woman's age and where one or both of the parents are carriers of a chromosomal disorder.
- undiagnosed condition - If the pregnancy is planned the woman should make sure that any existing condition is under control before she conceives. When recurrent miscarriages occur in a previously healthy woman, tests may be done to exclude any
DiagnosisCharting - By tracking a menstrual cycle, some problems can become apparent. Analysis of blood hormone levels will provide further information.
Early pregnancy will be detected by charting and this will allow for hormone support, where required, to be started quickly.
Blood tests - can reveal possible problems with hormones or the immune system.
Ultrasound scanning - can be used to examine the internal organs, ie uterus, tubes and ovaries. Laparoscopy - enables a gynaecologist to view the pelvic organs.
Hysteroscopy - using a telescopic instrument through the vagina and cervix enables a view of the inside of the uterus.
Hystersalpingogram - is an x-ray of the uterus and the fallopian tubes following the insertion of a dye.
Other forms of screening - can identify possible infections.
Progesterone treatment of miscarriage
Women who have low progesterone levels will be placed on a progesterone supplement in early pregnancy and the dosage regulated according to her blood progesterone levels.
Hormone treatment can help even before a baby is conceived. Natural progesterone can also be used to support a pregnancy. Antibiotics can cure infections. Surgery may be effective for some problems in the uterus or cervix if appropriate.
If you have a history of recurrent miscarriages
Have a complete medical examination before you attempt to get pregnant again. Try to make lifestyle changes, ie stop smoking, abstain from alcohol or chemical substances. If you think you are pregnant see your doctor as soon as possible.
Coping with recurrent miscarriages
The loss of a pregnancy, no matter how early or late, can result in grief or disappointment, which may overwhelm you. For many women the emotional healing takes longer than the physical healing.
If you need help to deal with your feelings, talk to those closest to you.
Counselling may be an option for you and your partner to help you recover.
Remember, you still have a good chance of having a successful pregnancy.