Recurrent Pregnancy Loss (RPL) is a condition when a woman has three consecutive miscarriages or abortions. Before a new pregnancy, such patients should have a thorough check up to identify the causes. Proper treatment can help solve the problem and a healthy child can be born.
Causes and treatments:
Lack of progesterone hormones
Progesterone hormone that secretes from corpus luteum is a pregnancy-friendly hormone. If abortion occurs in the 5th or 6th week of pregnancy several times, progesterone support is an effective method. Preparations should be taken as per the physician's advice from before.
Diabetes is one among the reasons for miscarriage. Those who are already diabetic patients must strictly control the condition and the ones who are diagnosed during a pregnancy should follow the prescribed rules.
Hypo and hyperthyroid may cause abortions. Hypothyroid patients are more common. The physician may prescribe Levothyroxine or anti-thyroid. The level of Thyroid Stimulating Hormone (TSH) should remain below 2.5 before pregnancy and through the first trimester.
The development of the foetus can be affected by high blood pressure. This can cause abortion. Blood pressure must be controlled. Drugs that are safe for pregnancy are to be taken.
Blood may clot in the case of lupus or antiphospholipid syndrome positive. The blood circulation to the foetus is interrupted in this condition. This may prevent the heart to stop beating. The antibody for lupus should be diagnosed if abortion is recurrent. The physician may prescribe aspirin and low molecular weight heparin in pregnancy.
One of the reasons for recurrent abortion is chromosomal complications. Karyotyping of parents’ chromosomes may be required in such cases. Upon the diagnosis and after a PGD test of the foetus, healthy foetus can be replaced using IVF method.
If the cervix is not strong, then it cannot hold the foetus and the water breaks. In such a case, the cervix begins dilating and opening too early leading to loss of pregnancy. This problem occurs more often in a second trimester. A cervical stitch called cervical cerclage may be required.
Tumours can cause pregnancy loss too. Also uterus septum or structure of the uterus may lead to abortion. Ultrasound or hysterosalpingogram can be used to diagnose such problems. In such cases, surgery is required before pregnancy.
RPL may lead to depression and psychiatric problems. The patient should be taken care of well. Most of the problems can be solved through diagnosis and treatment.
*Shahina Begum is a consultant of obstetrics and gynecology at BRB hospital.