Avoiding Repeat Miscarriages

Q: How do I avoid recurrent miscarriages?

A: Any known pregnancy loss can leave an emotional scar along with feelings of guilt and self-doubt. But even when a mom has done everything right—taken all precautions possible, exercised, ate a nutritious diet—miscarriages still can happen.

A miscarriage is a pregnancy loss that occurrs less than 20 weeks from a woman’s last menstrual period. It’s estimated that up to 50 percent of all pregnancies end in miscarriage. Most of these miscarriages happen, however, before women even know that they’re pregnant. Of known pregnancies, about 15 percent miscarry.

As disturbing as these statistics sound, imagine when a woman miscarries three or more times in a row. About 1 percent of all women deal with this gut-wrenching condition, known as recurrent pregnancy loss or recurrent miscarriage.

The reason for the majority of recurrent pregnancy losses is unknown. However, some medical conditions in the mother and in the fetus have been linked to these miscarriages:

• Random chromosomal abnormalities in the embryo; this unexplained “chance” event is the most common reason.
• Inherited genetic cause.
• Age of the mother; the chance of miscarriage increases with age—approximately one-third of all pregnancies for women 40 and older miscarry.
• An abnormality of the uterus, such as double uterus, fibroids and uterine polyps; some of these could be corrected by surgery.
• Hormonal and metabolic abnormalities in the mother; such as, poorly controlled diabetes, polycystic ovarian syndrome and possible association with low levels of progesterone.
• Autoimmune disorders such as antiphospholipid syndrome in the mother; this requires blood tests to check for the lupus anticoagulant and anticardiolipin antibodies.
• An inherited blood clotting disorder in the mother, such as Factor V Leiden, elevated levels of fibrinogen and others.

When a woman has had two or more known miscarriages in her first trimester, or one miscarriage in her second, she should be thoroughly evaluated by an obstetrician, a reproductive pregnancy loss specialist or a family physician trained in obstetrics and reproductive health. This examination likely will include: Blood tests (checking for immune disorders in the mother, hormone levels, chromosome abnormalities and other related conditions), an ultrasound of the uterus, hysteroscopy (viewing the uterus through the cervix using a special device) and endometrial biopsy.

Even with the best experts studying the results of the most accurate tests, we are left without a clear explanation for more than half of the repeat miscarriages.

However, there’s hope. Sixty percent to 70 percent of women with unexplained recurrent miscarriages will go on to have a successful pregnancy. And, if the cause is recognized and treatable, the success rate increases by up to 90 percent.

So what can you do to maximize your chances for a successful pregnancy? For starters, ask your physician if you would benefit from taking a daily vitamin B supplement known as folic acid. Next, consider incorporating a healthier lifestyle into your daily routine. Some suggestions:

• Eating a nutritious and well balanced diet.
• Quitting the tobacco habit.
• Avoiding secondhand tobacco smoke.
• Ceasing any alcohol consumption.
• Incorporating regular and low-intensity exercise, such as walking.
• Maintaining a healthy weight.
• Reducing caffeine intake.
• Keeping clear of unwanted radiation or toxic chemical exposure, including work-related chemicals.
• Checking with your physician or pharmacist before taking over–the-counter or prescription medications.
• Avoiding the use of illegal drugs.

How long you wait before attempting another pregnancy is a highly personal decision. While many experts recommend waiting until you have had at least one or two normal menstrual cycles for evidence of a physical recovery, it is just as important to give yourself time to heal emotionally and spiritually.

Source: MSN Health