DT Health: Minimise risks of recurrent pregnancy loss

Recurrent pregnancy loss largely remains a mystery even to science. We know that 15-20 per cent of the pregnant women carry the risk of recurrent miscarriages, the case of two or more pregnancy losses prior to 20 weeks of conception. But, 70 per cent of the time we do not know what exactly the underlying causes are. Sometimes, nature itself can abort, taking into account the health of the mother. But, there is zero science in attributing miscarriage to things like oily or non-veg food, travel and climbing stairs. They are simply myths.

Dr V Bharathi, Gynecologist & infertility specialist, Medical Director, Bharati Fertility Center

Scientifically well-established reasons and risk factors include hormonal imbalances, uterine anomaly and thrombosis.There are tests that can accurately diagnose these risk factors. When someone is diagnosed with a risk factor, it becomes easy to circumvent or eliminate it. For instance, if we find that there are uterine anomalies, we know both, the complications they can lead to and the steps for saving the pregnancy.

Usually, no specialised tests are required when pregnancy is lost for the first time. They are required only when it occurs more than two times. The tests are recommended based on the period of pregnancy, whether it is the first, the second or the third trimester.

Some of the specialised tests, include hysteroscopy, karyotype, Preimplantation Genetic Testing and fetal autopsy. Hysteroscopy is done to examine the inside of the uterus. It can find whether there are any uterus anomalies that can lead to miscarriages.

A karyotype test involves examining tissues of fetus to find out genetic disorders or chromosomal defects that can cause miscarriages.

Preimplantation Genetic Testing is used to examine embryos during in-vitro fertilisation for a range of genetic defects - say, a missing or an extra chromosome in the embryo that can cause pregnancy loss and birth defects.

Fetal autopsy is necessary to determine the cause of fetal death and the factors that may have had a role in it - besides the extent and cause of malformations. Only with accurate diagnosis is it possible for us to give proper counselling and an appropriate plan for a subsequent pregnancy.