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Recurrent Pregnancy Loss

1 in 4 Pregnancies ends in Miscarriage

    To attain pregnancy is an achievement but to deliver a healthy baby is a challenge !!!! Recurrent pregnancy loss represents one aspects of disordered fertility. Recurrent abortions are frustrating and disheartening to the couple. It is also a vexing clinical problem as the cause often remains unexplained. RPL requires time, dedication and carefully planned approach to its investigation and management. Even after through and systematic evaluation, in over 50% cases no predisposing factors can be identified. However, the incidence of RPL increases with the age of the couple. The defect is not always correctable.

    Miscarriage is defined as the spontaneous loss of pregnancy before the fetus reaches viability. The term therefore includes all pregnancy losses from the time of conception until 24 weeks of gestation.

    RPL is defined as the loss of three or more consecutive pregnancies of couple trying to conceive. It has been estimated that 1–2% of second-trimester pregnancies miscarry before 24 weeks of gestation.

    Various causes for habitual abortions can be :

    • Cervical pathology
    • Uterine pathology
    • Uterine malfunction
    • Chromosomal disorders
    • Endocrine disorders
    • Thrombophilia
    • Maternal Age
    • Partner Specificity
    • Luteal Phase Defect
    • Chronic exposures to intoxicants and Recreational drugs.
    • Certain Infections particularly tuberculosis
    • Maternal systemic disease
    • Unexplained miscarriages
    • Immunological causes

    Transvaginal ultrasonography plays a central role in the evaluation of uterine abnormalities, luteal phase defect, cervical incompetence, immune disorders and polycystic ovaries. It has also become the primary method of assessment of the health of an early pregnancy and to pick up chromosomally aberrant foetuse.

    In non-pregnant patients who are evaluated for RPL the following tests are usually performed.

    Parental chromosome testing (karyogram): It is generally recommended after 2 or 3 pregnancy losses.

    Following Blood tests are performed
    • Thrombophilia
    • Ovarian function
    • Thyroid function

Recurrent Pregnancy Loss Treatment in Amritsar

This depends upon the cause of miscarriage. In patients with unexplained RPL there are about 60-70% chance that the next pregnancy is successful without treatment. In certain chromosomal situations, while treatment may not be available, IVF with pre implantation genetic diagnosis may be able to identify embryos with a reduced risk of another pregnancy loss which then would be transferred. Surgical intervention for uterine malfunctions may prove useful. Even with appropriate and correct treatment another pregnancy loss may occur as each pregnancy develops its own risks and problems.