Recurrent Miscarriages, What Checks Should Be Done?
Good afternoon, r nI have miscarried 2x in a row of 6 and 7 weeks’ gestation. Then the 3rd pregnancy was born normally at the age of 36 weeks sc because of ruptured membranes without opening and without contractions. When I was 3 years old I became pregnant again but again miscarried at 9 weeks. Spontaneous abortion itself out of a small bag but the contents are only fluid and fetal candidates who are not appropriate for his age. R nWhat should I test? If I get TORCH, is it possible for a child to be born and be healthy? Or do I have blood coagulation? Which test should I do, ACA or TORCH remember the considerable costs if done both at once and who knows how to meet the problem with the selection of the right test. R nThank you
Hello Ambu Hanie,
Recurrent miscarriage or reccurent miscarriage is defined as a miscarriage that occurs for 3 times in a row with a womb under the age of 20 weeks. In research, if there is a miscarriage in the first pregnancy, the risk of miscarriage in the second pregnancy will increase. In women who experience miscarriages 2 times in a row, have the same risk of miscarriage with 3 times in a row. Factors that allow recurrent miscarriages include:
Genetic factors. Chromosomal abnormalities that are passed on to the fetus make the fetus unable to survive and develop, resulting in miscarriage.
Abdominal anatomy abnormalities. In abnormalities such as uterine bulkhead, the risk of miscarriage increases up to 70% compared to women with normal uterus. Other disorders such as fibroids (tumors), polyps, etc. can also cause miscarriages
Infection. Infections such as toxoplasma, rubella, cytomegalovirus, hsv. thought to increase the risk of miscarriage, although the mechanism is unclear. Infection causes inflammation of the uterus, aminonitis, or is suspected to infect the placenta (umbilical cord) and the fetus directly to cause miscarriage. But in the study, the incidence of recurrent miscarriages in women with the infection was only 0.5-5%. Miscarriages usually occur in immunocompromised women who experience the TORCH infection.
Immunological disorders. Occurs when the immune system in the mother's body, attacks the fetus that is considered a foreign object. Antiphospolipid antibody syndrome (APS), characterized by clinical symptoms of blood vessel obstruction or pregnancy complications including miscarriage 3 times in a row with a gestational age not reaching 10 weeks or 1x / more fetal death at age> 10 weeks or at least 1x preterm birth due to preeclampsia or impaired placental blood circulation. These clinical symptoms must be supported by positive blood laboratory tests (anticardiolipin antibody / ACA or lupus anticoagulant)
Hormonal disorders, such as hypothyroidism
Environmental factors and stress
Most miscarriages (> 30%) have no known cause. We recommend that before doing a blood test, you can consult in advance to an obstetrician to be able to rule out other possible causes.
Based on studies of patients who experience recurrent miscarriages, even up to 4x, have a 60-65% chance in the next pregnancy to be able to reach the term of the womb. So consult with your obstetrician to better prepare for the next pregnancy. Thus the explanation from me, may be useful.