Recurrent miscarriage (habitual) Causes

Recurrent miscarriage (habitual)

    * Introduction
    * Causes
    * Laboratory investigations
    * Treatment
back Causes
About 5% of pregnant women have two consecutive miscarriages and 1% have three or more consecutive miscarriages. However, it was established that even a woman who lost three pregnancies and received no specific treatment is likely to give birth to a healthy baby in about 50% of cases.
However, the results of previous pregnancies have an influence on the risk of miscarriage scauzuta the next task. The worst case is where all the previous tasks resulted in abortion, the risk increases with each successive miscarriage after the first two. Furthermore, as abortion occurred later in gestation with the greater risk of losing the next task. Even if the pregnancy is carried to term or a pregnant woman passing the first half of gestation period, current studies have shown that a woman with a history of spontaneous abortions have higher risk of having a fetus with intrauterine growth small or premature.
Establishing the causes of recurrent abortion may be a problem. First trimester pregnancy losses are often (but not always) caused by fetal genital defects. However, even at mid-pregnancy abortions products nongenetice cases, the same woman is not always the same etiology. The causes of recurrent abortions can include implantation factors, genetic factors, autoimmune factors, endocrine factors, anatomical defects and uterine infections.

 
Factors implantation

 
Implantation is a complex, a process that involves more fine-programmed interactions between maternal and fetal cell populations. Polypeptide factors called cytokines provide essential signals pozitv effect on implantation. The endometrium is an active provider of cytokines absolutely necessary phases of implantation. Therefore, a defect of cytokines may lead to implantation failure, but the exact mechanism has not been established.

 
Genetics

 
Approximately 50-60% of spontaneous abortions by quarter are genetic causes, the most common trisomy, monosomy X and polyploidy. These tasks are broken up as a defense mechanism against children with birth defects. Analyses carried out torque can diagnose chromosomal abnormalities (only 2-3% of couples) to any parent. A pregnancy with donated sperm or egg may be the only solution in this case.

 
Hormonal Factors

 
Progesterone deficiency is a common problem especially in patients who used ovulation induction agents. Hormonal support is very important during the first three months of pregnancy. Abnormalities of thyroid function and diabetes can also lead to abortion. However, they are potentially treatable with proper control of diabetes and thyroid normal pregnancy can result.

 
Anatomic factors

 
Form of uterine anomalies such as septated uterus, double uterus or womb fiber can also be causes of late abortion. Uterine cavity can narrow the near wall (intrauterine adhesions), causing abortion. A cervical dehiscence may sometimes not be able to maintain a pregnancy. All these cases can be treated successfully by surgery.

 
Immunologic Factors

 
There are certain antibodies in their blood that are upon the tissues. These are called autoantibodies. Among the multitude of autoantibodies, some have been associated with recurrent abortion. Most common are lupus anticoagulant and anticardiolipin antibodies. Others, such as antibodies antitiroida have no clear association with recurrent abortion. Treatment with low molecular weight heparin and aspirin is effective.

 
Infections

 
Although there is no clear evidence that infections can cause recurrent miscarriage, the mechanism of various infections may explain sporadic abortion, but not the appellant (metabolic toxic products, exotoxin, endotoxin, or cytokines). Infections may cause fetal death or fetal malformation incompatible with life. Chronic infections can interfere with implantation endometrium. Amniotic first trimester can cause miscarriage. Chronic genital infections with Listeria monocytogenes can cause repeated abortions, which can occur in immunocompromised women. Mzcoplasma, ureaplasma and chlamydia can cause endometritis and cervicitis and is found more frequently in women with a history of repeated abortion. However, clear evidence of such combinations has not been found yet. Syphilis can cause miscarriage in the second trimester of pregnancy, but is not associated with recurrent abortion. Primary infection with herps simplex virus (HSV) has been linked to spontaneous abortion and chronic infection with HSV with recurrent abortion. Toxoplasmosis can affect the placenta and fetus in the last quarter, but not a sufficient factor for recurrent miscarriage except immunocompromised women. Asymptomatic women infected with HIV have a higher risk of miscarriage. Symptomatic women are at risk. In practice there is no need, in general, the investigation of exotic infections, unless there is a history suggestive of these infections.

 
Psychological factors

 
Depression often is seen as a response to the loss of a pregnancy. Women may be in shock, denial, anger, anxiety and guilt. The importance of these experiences does not depend on pregnancy, but maternal attachment to the fetus. For women who have pirdut more tasks, emotional stress caused by each loss can be cumulative. Psychological counseling may be one of the most important forms of treatment in these cases.