Repeated abortion is the loss of a pregnancy naturally during the first 20 weeks of gestation. The repeated abortion rate is estimated to be around 15%, a probability that increases to 18% if the woman has previously had an abortion and 25-30% if she has had several previous cases. Normally it is necessary to find out the cause through a specific study when a couple has had two or more miscarriages.
What are the symptoms?
There are some miscarriage symptoms that don’t always translate into gestational loss. The threat of abortion is like a warning that this can occur. The main and most alarming symptom is massive vaginal bleeding. In the same way, unknown pain or annoying abnormal and high intensity discomforts can occur. On the other hand, the symptoms that can reveal an impending abortion are: abdominal pain, fever or weakness. At the first symptoms, the pregnant woman must immediately consult with her gynecologist.
Causes of repeated abortion
There are several factors that can cause miscarriages:
- Genetic factors: they represent 5% of cases in couples where there is a chromosomal problem in the karyotype of one of the members, but which is not known.
- Anatomical factors: they are uterine anomalies. Once resolved, the chances of having a child increase to 70-85%. These include:
- Adherences that form in the uterus that often arise as a result of previous scrapings
- Myomas or sepsis
- Endocrine factors: Obesity, polycystic ovary syndrome or altered levels of thyroid hormones or glucose are risk factors.
- Thrombophilia: these are pathologies of the blood circulation that predispose the patient to thrombosis. If they occur while the placenta is forming they can cause repeated abortion.
- Immunological factors: when in vitro fertilization is performed, it is essential that the mother has a correct immune response, since if the organism reacts by rejecting the embryo instead of protecting it, an abortion can occur.
- Male factor: the father’s age can be a trigger, especially if it is over 45-50 years old.
Can it be prevented?
In order to prevent repeated abortions, a thorough monitoring of pregnancy and parents is essential. Thus, a weekly ultrasound follow-up starting from the sixth week of gestation increases the probability that the pregnancy evolves correctly, thus reducing abortions. The weekly checkup will also help reduce stress and fear in parents. Therefore, the best way to avoid repeated abortion is to have patients undergo prenatal medical examinations, as well as help reduce parental stress through psychological support.
What is the treatment?
Depending on the primary cause that causes repeated abortions, the specialist will propose one or the other remedy: among these, surgical hysteroscopy, endocrine therapy (hormonal disorders), anticoagulants, genetic test by pre-implantation of embryos. It is important, in any case, that the couple is followed by a multidisciplinary team of endocrinologists, gynecologists, andrologists, psychologists, etc.: they will be able to recommend the best treatment options.
