Miscarriage (cont.)
Can something be done to prevent future miscarriages?
The treatment of recurrent miscarriage depends on what is believed to be the
underlying cause. This often is not as simple as it sounds. Careful evaluation
may turn up several potential factors which alone or together may be responsible
for the losses. If a chromosomal problem is found in one or both spouses, then
counseling as to future risks is the only option for the couple, since there is
currently no method to correct genetic problems.
If a structural problem is encountered with the uterus, surgical correction
could be contemplated. It should be emphasized that just because a structural
abnormality is found, it does not necessarily mean that it caused the
miscarriage. Removal of a fibroid or uterine septum does not guarantee a future
successful pregnancy, since the fibroid or uterine septum may not have been the
cause of miscarriage in the first place.
Adequate control of diabetes and thyroid disease is
critical in trying to prevent recurrent pregnancy loss in women with those
conditions. For women with immunologic problems, certain medications are being
studied that may be useful in achieving successful pregnancy outcomes. Blood
thinners such as aspirin and
heparin can, in some cases, prevent further pregnancy loss.
The use of progesterone to increase the blood levels of
this hormone is sometimes used for patients with recurrent pregnancy loss,
although large-scale controlled studies that confirm the utility of progesterone
supplementation have not been carried out. However, many physicians report
success with progesterone therapy. Progesterone may be given as vaginal suppositories, or in tablet or gel
form. In dealing with recurrent pregnancy loss, it is important to realize that
even though apparently obvious problems can be corrected, a miscarriage can
still occur. This is not to say that attempts should not be taken to correct
identified abnormalities that have been historically associated with
miscarriage. However, no treatment can be guaranteed. Even with repeated
miscarriages, there is still a very good chance of achieving a successful
pregnancy. Early pregnancy and pre-pregnancy counseling can help identify risk
factors and allow the practitioner to provide any special care that may be
needed.
- Spontaneous miscarriage is the loss of a pregnancy
that ends spontaneously before the fetus can survive.
- Exercise, working, and intercourse do NOT increase
risk of miscarriage for women without underlying specific medical conditions
that place them at risk.
- Causes for miscarriage include genetic abnormalities,
infection, medications, hormonal effects, structural abnormality of the
uterus, and immune abnormalities.
- After an isolated miscarriage, the chance of having a
normal term pregnancy in the future is near 90%.
- Treatment of recurrent miscarriage is directed toward the underlying cause.
Previous contributing medical Authors
Leon J. Baginski, MD, FACOG, and Carolyn J. Crandall, MD, FACP
Last Editorial Review: 1/12/2007
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