Gynaecology › Recurrent Miscarriage
Recurrent Miscarriage
A pregnancy loss is not only a medical event; when it happens repeatedly it becomes an exhausting experience. The purpose of investigation is to identify a cause where one can be found, and to place the next pregnancy on safer ground.
When investigation is offered
Investigation is advised after two or more consecutive pregnancy losses. It may begin earlier where there is older maternal age, losses at later gestations, or a family history of a clotting disorder.
What is investigated
- Chromosome analysis (both partners together)
- Uterine structure: septum, polyp, fibroid, adhesions
- Thyroid function and glucose control
- Antiphospholipid syndrome and thrombophilia
- Prolactin and ovarian reserve
- Immunological factors
What is found
Despite full investigation, no specific cause is identified in a substantial proportion of couples. That result is not a reason for despair: the great majority of couples with unexplained recurrent loss go on to complete a healthy pregnancy with close monitoring.
Treatment and monitoring
- Hysteroscopic correction of structural problems within the cavity
- Stabilising thyroid function and glucose control before pregnancy
- Anticoagulant treatment in antiphospholipid syndrome
- Pre-pregnancy preparation including folic acid and vitamin D
- Frequent early ultrasound and close monitoring
- Avoiding smoking, alcohol and excess caffeine
The emotional burden
- Anxiety and grief are a natural part of this process, not a weakness
- Support from a partner or family makes a measurable difference
- Psychological support, where needed, is part of treatment rather than an admission of failure
