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| Recurrent Miscarriage | The definition of a recurrent miscarriage varies depending on the doctor asked. Most doctors are of the same mind that after three miscarriages a woman would be considered to have a recurrent miscarriage. There are some doctors who will start a medical evaluation after two back to back miscarriages, while other physicians will wait for three miscarriages.
Signs and Symptoms
A recurrent miscarriage similar to other miscarriages may have vaginal bleeding which is the most common sign and symptom of miscarriage. Other signs and symptoms may include abdominal cramping, a large amount of fluid that is discharged from the vagina, vaginal spotting, a positive pregnancy test which turns negative, a decreasing serum hCG level, inability to see or hear fetal heart tones, and pain or pressure in the lower back or pelvis.
Causes
There are several causes for a recurrent miscarriage and at times an extensive medical evaluation needs to be done to find out the real cause. One cause is genetic abnormalities within either the mother or the father. The chromosomal abnormality is a translocation (movement of a portion of one gene to another) which may be found in about 4% of couples.
Other causes include:
 infection (ie. Chlamydia, Cytomegalovirus, Genital herpes, Syphilis, Toxoplasmosis, and Rubella);
abnormal uterine anatomy (ie. unicornate uterus, septate uterus, etc.);
incompetent cervix;
abnormal hormonal levels within the mother (ie. low progesterone);
systemic illnesses (ie. untreated thyroid disease or diabetes);
immune disorders;
substance abuse.
Treatment
Actually, the treatment for a recurrent miscarriage is finding the original cause of the recurrent miscarriage. This involves possibly performing genetic testing on the mother and father to exclude possible chromosomal translocations. Blood tests can be done to measure for possible hormonal abnormalities, immune disorders, or systemic illnesses within the mother. Cervical cultures can be performed to evaluate for possible infections. Evaluation of the anatomical condition of the uterus should also be performed to exclude any abnormalities. If an incompetent cervix is the cause of the recurrent miscarriage then a cerclage (a stitch is placed into the cervix to prevent dilatation) can be placed to treat the woman. If substance abuse is considered to be a cause of a recurrent miscarriage, then substance abuse counseling should be given to the woman.
Another aspect of a recurrent miscarriage that should be taken to consideration and added to the treatment plan is the coping of a recurrent miscarriage. The couple will be awfully nervous getting pregnant again and also awfully devastated at another miscarriage.
It is advised that a couple wait as a minimum one regular menstrual cycle before trying to conceive again after a recurrent miscarriage.
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