What are recurrent miscarriages?

RecurrentWhat are miscarriages?

Three or more baby loss (miscarriage) before 20 weeks or weighing 500 grams is called recurrent miscarriage. Some doctors today accept 2 or more. It is a condition that affects approximately 1% of couples of reproductive age.

Those within the first 12 weeks are called early miscarriages. 12-20. Miscarriages between weeks and weeks are called late miscarriages.

Recurrentwhy low?

Since it occurs with the effect of many factors, no underlying cause can be found in approximately half of the patients, even if all investigations are carried out.

in babygenetic abnormality

It is the most common cause of early miscarriage. In approximately 70% of miscarriages, genetic disabilities occur in the baby. If the woman’s age has reached the advanced age of women (over 35 years old), this rate increases even more. 13-20. In only 20% of abortions, a genetic disability is detected in the baby. The majority of infant disabilities are trisomy, polyploidy, or monosomy. Genetic analysis is necessary to determine the karyotype of the miscarried baby. Detection of a genetic disability in the baby is actually a good indicator. Because the next pregnancy has a 75% chance of being normal.

Important warning

Having a genetic disability in the baby is not caused by the abnormal genetics of the parents. The genetics of the parents are mostly normal.

Mom dadgenetic problems

In patients with recurrent miscarriages, the chance of having a genetic disability in the mother and father is 2%. These disabilities are usually balanced translocations (Balanced translocation, 47,XXY—Klinefelter syndrome, etc.). If a genetic disability is detected in the mother or father, a genetic specialist should be informed. Today, we can analyze the gene of the embryo in IVF with a method we call PGD. PGD ​​can be very beneficial in these patients. As a result of the examination of the embryos, normal embryos are placed in the uterus.

Click here to watch the genetic examination of embryos (PGD) process in IVF treatment.

Uterusinjuries

The incidence of uterine disorders such as intrauterine veil, half uterus, double uterus or arcuate uterus in the society is 6.7%. In patients with recurrent miscarriages, this rate is 16.7%.

Acquired fibroids (especially large fibroids that press into the uterus in the uterus), intrauterine adhesions, polyps in the uterus can also cause recurrent miscarriages.

Bloodcoagulation disorders

Defects in one or more of the enzymes that control blood clotting can cause blood to clot more quickly. In this case, while the embryo must adhere to the uterus and reach the mother’s blood vessels, very small blood vessels coagulate and miscarriage occurs due to no blood flow to the baby.

Conditions such as factor 5 leyden mutation, activated protein C resistance, Antithrombin 3 deficiency, prothrombin G20210A mutation, protein C, protein S and protein Z deficiencies, hyperhomocystinemia, MTHFR can cause recurrent miscarriages. However, great care must be taken while performing these tests. Because the tests can be positive in 20% of women who have given birth normally, without any problems.

Defensesystem diseases

In 15% of those with recurrent miscarriages, diseases related to the defense system are detected. Diagnosis is made in the presence of antiphospholipid syndrome and systemic lupus disease.

The following conditions are required for the diagnosis of antiphospholipid syndrome.

Clinic (1 is enough)

1. Unexplained miscarriage over 10 weeks

2. Preterm labor before 34 weeks

3 or 2 or more miscarriages before 10 weeks

Laboratory (1 is enough)

Anti-Cardiolipin IgG and/or IgM positive 2 times (checked at 12-week intervals)

Anti-Phospholipid IgG and/or IgM positive 2 times (checked at 12-week intervals)

Positive anti-β2 glycoprotein IgG and/or IgM twice (checked at 12-week intervals)

At least 1 clinical and 1 laboratory positive must be present for diagnosis.

Prednisolone and intravenous antibody therapy are of no benefit in the presence of antiphospholipid syndrome. The benefit of aspirin and low molecular weight heparin alone has also not been demonstrated. Co-administration of low dose (80 mg) aspirin and low molecular weight heparin reduces the miscarriage rate by 54%.

The American Obstetrics Society recommends administration of low dose (80 mg) aspirin and low molecular weight heparin for treatment.

anti-thyroid antibodies

Presence of anti-thyroid antibodies may be associated with recurrent miscarriages. In a small-scale study, it has been shown that levothyroxine treatment reduces the miscarriage rate if anti-thyroid antibodies are present even though thyroid tests are normal.

Natural killer cells

These cells play a very effective role in the adhesion of the baby to the uterus. The oversensitivity of these cells prevents the baby from being buried in the mother’s uterus. Treatments that suppress these cells, such as steroids, are unfortunately not effective. More studies on this subject are needed.

Endometrial cytokines

Although studies on animals have shown a relationship between endometrial Th1–Th2 cytokines and low levels, studies on humans are newly conducted.

Hormoneproblems

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