Miscarriage occurs in 15 to 25% of pregnancies. The rate of miscarriage risk increases
markedly when a woman passes the age of 40, approaching 50% probability in some
studies. Most miscarriages are due to chromosomal abnormalities, but other causes
may be related to anatomic, hormonal, infectious, or immunological abnormalities.
Spontaneous abortion is the technical name for miscarriage.
Recurrent miscarriage is usually defined as at least three miscarriages with no
more than one pregnancy extending into the third trimester. When a couple presents
with this history, the physician attempts to identify any abnormalities that may
be causing the frequent losses. A direct cause is found less than half the time
these evaluations are performed. Fortunately, couples with such unexplained recurrent
miscarriage usually have a high chance of a successful subsequent pregnancy.
If the woman does get treated for recurrent miscarriage and subsequently gets pregnant,
it is difficult to know whether the treatment was responsible for the pregnancy's
success. Unfortunately, few studies have been well done on this subject, and many
of the suggested treatments are expensive and experimental.
Common tests performed on a couple who have experienced recurrent miscarriages include
checking their chromosomes (karyotypes), checking a woman's uterine anatomy (3D
and 4D Ultrasound), evaluating common hormonal problems (thyroid, prolactin, glucose),
and checking for common immunologic problems (antibody testing). Treatment can vary
in complexity, ranging from taking aspirin each day or undergoing an out-patient
surgical procedure to remove a fibroid (hysteroscopic myomectomy) to undergoing
complicated immunotherapy.
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