Recurrent miscarriage is defined as the loss of three or more consecutive pregnancies. The risk of further abortion increases with each recurrent miscarriage. But there are high chances of a successful pregnancy too.
The treatment of recurrent pregnancy loss involves medications, surgery, genetic testing and lifestyle changes. It usually depends on the causative factors.
Interconceptional period
The interconceptional period is the time from the end of one pregnancy to the start of the next pregnancy. During this period, the anomalies found can be corrected.
Counselling
Counselling of the couple is done to remove the anxiety. They should be assured that even after three consecutive miscarriages, the chance of a successful pregnancy is high (70%).
Anatomical abnormalities
Minor surgeries can be done to correct uterine malformations. Hysteroscopic resection of uterine septa and uterine unification operation for bicornuate uterus can be done.
Chromosomal anomalies
If a chromosomal abnormality is detected in the couples or in the abortus, then genetic counselling is undertaken. Couples with chromosomal abnormality is counselled for preimplantation genetic diagnosis or prenatal diagnosis (amniocentesis or chorionic villus sampling) in a subsequent pregnancy to detect at the earliest the chromosomal anomalies in the foetus.
Endocrine dysfunction
Diabetes and thyroid disorders are controlled before you go for another pregnancy.
Genital tract infections
If genital tract infections are the cause of recurrent miscarriage then it should be treated appropriately following a culture of cervical and vaginal discharge. Treatment with doxycycline or erythromycin is found effective.
During pregnancy
When a woman experiences recurrent abortion, she gets distressed. Reassurance and tender loving care are very much helpful to remove the stress and it also improves uterine blood flow during pregnancy. You should take adequate rest, avoid strenuous activities, intercourse and travelling during pregnancy.
Ultrasound should be done at the earliest to detect a viable pregnancy. This will help in further management.
Luteal phase defect
Luteal phase defect cases are treated with natural progesterone and it should be continued for 12 weeks. HCG therapy is also helpful to improve pregnancy outcomes.
Immunological causes
Antiphospholipid antibody syndrome (APS) is treated with low dose aspirin or low dose aspirin and heparin up to 34 weeks or prednisone. IV immunoglobulin is also used.
Inherited thrombophilias
Thrombophilias are blood clotting disorders and are treated with antithrombotic therapy so that pregnancy outcomes can be improved. Heparin is found effective and given up to 34 weeks.
Cervical Incompetence
In case of cervical incompetence, a cerclage operation is to be performed in which a non – absorbable encircling suture is placed around the cervix at the level of the internal os.
Conclusion
In the above post, we have discussed different treatment modalities for recurrent miscarriage. Treatment usually depends on the causative factors. After undergoing treatment, there are high chances of a successful pregnancy. However, tender loving care and some supportive therapy improve the pregnancy outcome by 70%.
Thank you all!!! Hope you find this useful.
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