Recurrent Pregnancy Loss

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Dr. (mrs) Umesh N. Jindal

Posted By : Dr. (mrs) Umesh N. Jindal - M.D

Posted On : Oct 19, 2007 (Views : 15369)

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An abortion is a personal and emotional loss to a young couple who is planning to start a family. When this problem occurs repeatedly the emotional trauma is compounded manifold.


Definition : Any pregnancy loss before 20 weeks of gestation (4 completed months) is called an abortion. It is further divided into


Early losses (Embryonic i.e. before 9 weeks or one month after missed period) Embryonic losses occur before the full development of baby and are associated with genetic abnormalities in the baby. This type of abortion is generally associated with a small or delayed appearance of gestational sac in ultrasound, empty gestational sac or non-appearance of cardiac pulse.


Late abortions (fetal i.e. from 9 weeks to 20 weeks of pregnancy)


Late abortions more commonly occur due to other factors like abnormalities in the uterus or immunological factors which I am going to describe in detail.



Risk of recurrence



: The two most common questions asked after abortion Are why it occurred? And what are the chances of recurrence?


15 ? 25 % of all pregnancies end up in abortions. One sporadic abortion generally does not increase the risk of repeated abortion. Only about 1% of women have recurrent abortions on two or more than two occasions. Risk increases with the number of abortions a woman has. 



Causes of Recurrent abortion



 


Genetic Factor : Almost 40-50% of all early losses are due to genetic abnormalities in the baby. These pregnancies are terminated by nature itself as a defence mechanism against the birth of abnormal babies. Chromosomal investigation of the couple may reveal abnormalities (only in 2-3 % of couple) in any of the parent. A pregnancy with donor egg or sperm may be the only answer.


Hormonal Factor :  Deficiency of progesterone or luteal phase deficiency is a common problem especially in patients who conceive with the help of ovulation inducing agents and ART. Hormonal support is very important during first three months of pregnancy.


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