Tag Archives: Miscarriage

Miscarriage: Cause & Impact

November 27, 2021 admin Leave a comment

A “spontaneous miscarriage” is the loss of a pregnancy before gestation of 20 weeks. Nearly 80% of spontaneous miscarriages occur within the first 12 weeks of pregnancy. While approximately one in four pregnancies end in miscarriage, many of these unfortunate events aren’t detected since these occur very early during pregnancy.

What causes a miscarriage?

A miscarriage usually occurs because the pregnancy is not developing properly. While a large number of miscarriages occur as a result of genetically abnormal embryos, there could be a plethora of factors responsible. These include:

# Random chromosome disorders

# Blood clotting disorders

# Hormonal disorders

# Submucosal fibroids

# Structural abnormalities in the womb

# Hormonal issues linked to polycystic ovaries

# An inherited genetic abnormality

# Being over 35 years of age, with a decline in quality of eggs

# For men over 40, the quality of sperm decreases, raising the risk of miscarriage

How does a woman understand that she’s having a miscarriage?

Look out for the following signs:

# Heavy bleeding

# Severe abdominal or shoulder pain

# Fever or chills

# Dizziness or fainting

# Vaginal discharge with an unpleasant odor

# Diarrhoea or cramps

A miscarriage can trigger a whole gamut of emotional upheaval, particularly in the woman. Regardless of whether the pregnancy is planned or unplanned, the emotional impact of miscarriage can be great, and that’s perfectly normal. A sense of profound loss is very common and expected, and though people may react differently to this tragic event, the loss can bring on:

# A sense of total emptiness

# Anger and utter disbelief

# A crestfallen feeling

# Acute melancholy and a sense of isolation

But remember that it’s important to stay positive while riding out the emotional rollercoaster, and summon up enough courage and willpower to try again. This is when one needs the love and support of family and friends. Do not shut out the people who care for you and do not hesitate to turn to them for encouragement and support.

Do not give up hope, you have to try again!

However, while trying for another pregnancy after a miscarriage, remember to:

# Quit smoking

# Exercise regularly and follow a balanced diet

# Reduce stress

# Watch your weight

# Take folic acid tablets

Is any treatment required for a miscarriage?

Once a miscarriage has begun, it can’t be reversed. So the doctor would typically try to prevent heavy bleeding and infection as the main treatment protocols, besides providing emotional support. Heavy bleeding with clots and cramps would indicate that the patient is still passing the pregnancy tissue. These symptoms should settle once most of the pregnancy tissue has been passed.

Sometimes, following a miscarriage, some residual pregnancy tissue remains in the uterus. Doctors then use a spoon-shaped instrument called a curette to scrape the uterus, a procedure called ‘dilation and curettage’, usually performed under a light general anaesthetic and the patient can go home the same day.

The role of IVF in miscarriage

In recurrent miscarriages, IVF or In Vitro Fertilization with genetic testing “can significantly minimize the risk of miscarriage and improve chances for a safe and successful pregnancy”.

# Genetic screening: Since genetic abnormalities in the embryo are the most prevalent cause of miscarriage, genetic screening is a very useful tool.

# Embryo screening: Doctors can now screen for chromosomal abnormalities and identify the healthiest embryo for implantation with a very high degree of accuracy.

# Frozen embryo transfer: In thisform of IVF treatment, a cryopreserved embryo created in a full IVF cycle is thawed and transferred to a uterus.

# Single embryo transfer: In thisprocedure, a single embryo, selected from a larger pool of available embryos, is placed in the uterus.

# Fertility care: This is extremely beneficial since tests prior to treatment can determine the risk for miscarriage and, possible contributing factors.

# Supervision & monitoring: Close supervision and monitoring is part of fertility care and helps mitigate risk and optimize chances for an ongoing pregnancy and live birth.

A miscarriage is more often than not precipitated by a combination of factors over which one had little control and it’s a wrong notion that the event has a propensity to recur. Women who have miscarried once or twice, are usually not sent for tests since it’s highly unlikely that anything would be found amiss. However, those who have had three back-to-back miscarriages, are at risk of miscarrying again, and must seek medical advice.

Pregnancy

5 Things You Should Know About Recurrent Pregnancy Loss (RPL)

June 16, 2021 admin Leave a comment

Pregnancy loss is usually hard to deal with and difficult to discuss. It is sad and personal, but not uncommon or unnatural. Certain myths surrounding pregnancy losses often make it harder for the person going through it. This blog tries to unravel long-standing misconceptions about pregnancy, miscarriage, and recurrent pregnancy loss and start an open conversation that may lift the burden of secrecy and stigma, and help couples cope with recurrent pregnancy loss, understand the furture implications.

What is Recurrent pregnancy loss?

Recurrent pregnancy loss or RPL is defined as having two or more miscarriages. After two miscarriages, an examination and testing are recommended.

What tests are available to find the causes of repeated miscarriages?

To help find the cause of repeated miscarriages, your healthcare professional will ask about your medical history and past pregnancies. A complete physical exam, including a pelvic exam, might be conducted. You may have to undergo blood tests to detect underlying issues with the immune system. Testing can be done to detect genetic causes of repeated pregnancy losses. Imaging tests may be considered to find if a uterine problem is causing recurrent pregnancy loss.

Can recurrent pregnancy loss cause infertility?

There is no evidence to suggest that RPL causes infertility. However, there is a possibility that a woman who has experienced pregnancy loss might experience another. This is most commonly due to underlying health conditions.

What causes recurrent pregnancy loss?

According to ACOG, approximately 60% of all recurrent miscarriages are a result of a genetic abnormality. As a woman ages, the risk of miscarriage resulting from genetic abnormalities increases – from 15 to 20% if she is under 35, to more than 50% if her age is over 40. The common causes of pregnancy loss include the following:

Genetic abnormalities

Genetic abnormalities can occur when an embryo is the recipient of an abnormal number of chromosomes during fertilization. In approximately 2–5% of couples with recurrent miscarriage, one of the partners carries a balanced structural chromosomal anomaly (Reciprocal or Robertsonian translocation). Their pregnancies are at ncreased risk of miscarriage and may result in a live birth with unbalanced chromosomal arrangement. The risk of miscarriage is influenced by the size and genetic content of the rearranged chromosomal segments.

Anatomic abnormalities

A septet uterus, in which a wall of tissue divides the uterus into two sections, occurs commonly and may result in recurrent pregnancy losses. While it is not clear why this leads to recurrent pregnancy losses, some believe that poor vascularity in the septum prevents the embryo from growing if it implants there. If the pregnancy makes it to term, the fetus may be breech. However, removing a uterine septum is easy surgically. An incompetent cervix cannot remain closed due to weakened muscles. As the developing fetus reaches a certain weight, the weakened cervix cannot support the fetus and often results in miscarriage.

Medical conditions

Certain medical conditions tend to increase the risk of recurrent pregnancy losses, including:

Antiphospholipid syndrome (APS) – An autoimmune disorder that occurs when a person’s immune system makes antibodies necessary for blood clotting
Thyroid/hormonal issues – An overactive or underactive thyroid can result in hormonal imbalances, which can cause a miscarriage if the uterine lining does not develop normally for implantation and nourishment of a fertilized egg. Elevated prolactin (reproductive hormone produced in the pituitary gland) levels can alter the development of the uterine lining
Fibroids and polyps – Non-cancerous growths that can invade the uterus
Asherman’s syndrome – A condition where scar tissue forms inside the uterus, causing miscarriage

How is Recurrent Pregnancy Loss treated?

The treatment of RPL must be based on imaging, clinical, and laboratory findings. Couples in which one of the partners carries a chromosomal rearrangement or abnormality should be referred for genetic counseling to discuss the probability of viable pregnancy based on the chromosomes involved. Women with intrauterine adhesions, a uterine septum, or uterine fibroids (especially submucosal fibroids) can choose surgical corrections, which per research is associated with reduced risk of pregnancy losses.

Next Steps Following Pregnancy Loss

It is essential to know that pregnancy loss does not mean that you will not be able to have children. Most people suffering a miscarriage will go on to give birth to a healthy baby. Even if pregnancy loss is recurrent, there are still treatment options. Besides a fertility specialist, a reproductive endocrinologist is often the go-to-specialist (or is part of the team) that offers treatment for recurrent pregnancy loss.

What to Expect from a Fertility Specialist in Kolkata Following an RPL?

Your experience with a recurrent miscarriage specialist will start with a consultation visit where you can expect to discuss the medical history and plan further evaluation. For a thorough diagnosis, your partner also needs to attend the initial appointment. Depending on your needs, you may be referred to a fertility specialist in Kolkata, who may ask you to take a range of tests, including some anatomical, hormonal, and autoimmune ones. Those undergoing the procedures can get home the same day. Once a fertility specialist is aware of the problem, they can even recommend a fertility treatment plan tailored for your needs.

Pregnancy

Breaking the Silence around Miscarriage

December 8, 2020 admin Leave a comment

In July 2020, Meghan Markle shared her “almost unbearable grief” at having lost her child to a miscarriage. The Duchess is not the first royal to share the experience of pregnancy loss as Sophie Wessex and Prince Edward earlier opened up about their traumatizing pregnancy loss.

The Duchess hoped that by sharing her story she might be able to remove some of the stigma that exists around pregnancy loss to this day. While, 2.6 million babies are stillborn and an estimated 85 percent of miscarriages happen before the 12th week of pregnancy every year, it is a topic that many still consider taboo.

What is a Miscarriage?

A miscarriage — in medical jargon indicates spontaneous abortion — is the unexpected end of a pregnancy before 20 weeks gestation. During a miscarriage, an embryo or foetus is spontaneously expelled from the uterus but is incapable of surviving in the outside world. After 20 weeks, the loss of a foetus is called a stillbirth but not a miscarriage.

What Causes a Miscarriage?

Miscarriages are not caused by moderate exercises, falls, sex and stress at work, fights with a spouse, or morning sickness. Rather, a miscarriage is a biological way of ending a pregnancy that is not going right.

The loss of the foetus or embryo and its expulsion from the uterus can be caused by factors, ranging from genetic defects to immune reactions in a mother’s body. Research suggests that half of all early miscarriages are connected to abnormal chromosomes.

Often, the causes of a miscarriage cannot be pinpointed at all. And in almost every case, there’s nothing the mother did wrong that led to the miscarriage or could have possibly done differently to prevent it.

Symptoms of Miscarriage

The symptoms of a miscarriage can vary from woman to woman and in some cases, can be completely different if some woman. But the most common signs include:

Vaginal bleeding can start as a dark brownish discharge. There may be blood clots or other tissue passing from your vagina with heavy bleeding. However, not all bleeding during pregnancy indicates a miscarriage. Especially when there ‘spotting’ characterized by a small amount of bleeding, many pregnancies continue to be healthy.

Cramps or other pain in the lower back, the pelvic area or abdomen

A decrease in the usual signs of pregnancy, such as breast tenderness and nausea may in rare cases signify miscarriage.

In addition to the possibility of miscarriage, pain or vaginal bleeding during pregnancy can be caused by other problems, such as an ectopic pregnancy. These symptoms should prompt an immediate consultation with your doctor, midwife, or nurse practitioner.

Miscarriage During the Pandemic

While there may be no way to erase the challenges of miscarriage during a pandemic, there are some steps that can be taken to cope and make you feel empowered.

Find alternative ways to connect: While the value of in-person contact cannot be replaced, consider other ways of connecting with friends and loved ones like virtual happy hours or virtual games such as trivia. It may also be helpful to set a regular time for these hangouts, such as Saturday night, to ensure you get that much needed time with your own people.
Allow yourself to grieve: As mentioned, in the backdrop of significant losses and suffering this year, it can feel difficult to grieve the loss of pregnancies. Attempting to hold yourself back from grieving is like fighting quicksand, you will find yourself stuck even more. Giving yourself the space to grieve will allow you to move forward in the healing process.
Connect to resources: Online support groups and miscarriage associations on Facebook and other online channels provide help. Additionally, it can be helpful to seek support through therapy.
Find your anchor: Whenever you find yourself caught in a sea of intense emotions, it can be helpful to identify your anchor to keep you grounded. Your anchor maybe your loved ones, your passion or the most helpful coping skill you use like meditation or journaling.

While there’s so much we do not know about what the future holds for us, we know that there is support, we know that we are not alone, and that we’ll get through.