Recurrent Pregnancy Loss: Causes, Symptoms & Impact

Key highlights:

• WHO defines recurrent pregnancy loss as three or more consecutive spontaneous miscarriages before 20-28 weeks of gestation.
• Habitual abortion is known to be caused by genetic, endocrine, uterine, and immunologic factors.
• An overview of recurrent pregnancy loss, miscarriage symptoms, and its impact.

What is Recurrent Pregnancy Loss?

Recurrent pregnancy loss cases have been stable for decades; it is traditionally known as habitual abortion. Repeated miscarriages cause physical and psychological impacts; however, they do not eliminate the chances of becoming parents. It is defined as two or more consecutive pregnancy losses before 20-24 weeks of pregnancy. It is categorised as primary and secondary, with primary being multiple losses before any live birth and secondary being multiple losses before a live birth. 80% of pregnancy losses occur in the first trimester. In this blog we will be learning about recurrent abortions, their causes and miscarriage symptoms.

What are the causes of recurrent pregnancy loss?

Genetic and Chromosomal Factors

Abnormal chromosome numbers in a developing embryo are medically termed “embryo aneuploidy.” In some cases, inherited structural rearrangements are passed from parents, known as parent translocation.

Hormonal & Health Conditions

Uncontrolled hyperthyroidism or hypothyroidism causes the body to slow down or speed up and impact the body’s health and weight. Increased blood sugar and fertility-related issues like PCOS or hormonal imbalance also contribute to pregnancy loss.

Uterus Abnormalities

The congenital wall of tissues divides the uterus since birth; this issue is known as a septate uterus. While the other abnormalities are formed over time in the womb, the categories include fibroids, polyps, or intrauterine scar tissue. 

Immune and Blood Clotting Disorders

An autoimmune issue known as antiphospholipid syndrome, it creates abnormal blood clots that impact the placenta. Genetic blood-clotting disorders affecting the blood flow to the placenta are also caused by inherited thrombophilias.  

What are lifestyle factors that cause recurrent pregnancy loss?

Genetic disorders along with daily habits also lead to recurrent pregnancy loss; the factors include:

High Substance & Caffeine Consumption: Smoking toxins restricts blood flow to the fetus, while high or regular alcohol consumption harms early development and leads to spontaneous abortion. Daily high intake of coffee also increases the risks of miscarriage

Recreational Drugs & Toxin Exposure: Illegal drug consumption impacts the blood flow to the fetus and impacts uterus stability. Regular or high exposure to environmental chemicals, heavy metals, or radiation impacts reproductive health.

Stress & Work Schedule: High or constant psychological stress with poor work-life balance creates a negative impact on hormone levels. This hormonal disruption may trigger misscarriage.

What are Miscarriage Symptoms?

Here are the 5 common miscarriage symptoms most women face during loss of pregnancy or misscarriage:

• Vaginal bleeding: Light spotting that progresses to heavy flow within hours or days with light red, dark brown, or pinkish watery discharge. Light spotting is considered normal in the first trimester; however, heavy flow is strongly associated with urgent medical attention.
• Severe abdominal cramps: Constant dull pain or severe sharp pain in the lower abdomen, pelvic floor, or lower back; it is caused by the constant contraction of the uterus while trying to expand. This occurs in a rhythmic wave pattern similar to labor pain with tightening and contraction.
• Passing tissue:

One may pass dark red, jelly-like blood clots ranging from the size of a grape to an egg. This flow is unlike the regular period, as you may pass the tissues consisting of placenta parts or a sac. The tissues appear grey, pinkish, or fleshy in color. The doctors usually suggest storing these tissues in a lab to check for complete miscarriage.

• Fluid Discharge:

Sudden and permanent tearing or bursting of the amniotic sac can lead to a slow trickle of pink or pale yellow fluid. The fluid is watery and may or may not be followed with immediate tissue or blood flow.

• Loss of Pregnancy Signs:

When the body goes through silent miscarriage or loss of pregnancy, there are no major severe symptoms. However, the pregnancy symptoms like hormones, tender breasts, nausea, and a growing stomach disappear.

Any of the above miscarriage symptoms appear during pregnancy loss. While silent miscarriage occurs when the fetus has stopped developing but the body has not yet expelled it, and the miscarriage is surprisingly visible only through prenatal checkups.

What is the physical and emotional impact of recurrent pregnancy loss?

Recurrent pregnancy impacts the couples in multiple ways, especially the women. The physical and emotional impacts are as follows:

Physical Effects: 

Recurrent miscarriage treatment often requires dilation or a medical surgery procedure to clear the uterus; this might cause risks of infections or may impact future pregnancy. It also leads to a sudden drop in hormonal levels and causes fatigue and nausea. Regular physical examinations like scanning, blood tests, genetic karyotyping, and hysteroscopy can be physically tiring and financially burdening.

Emotional & Psychological Effects:

Recurrent pregnancy loss is emotionally and mentally draining; it might lead to stress and anxiety. Couples, especially women, might go through the constant guilt of child loss. People fear the inability to reproduce again and are tormented by the society’s hurtful comments. The emotional and physical strain also impacts future pregnancy. It creates a sense of hypervigilance; the mind might also create a defense mechanism while bonding with the new baby.

Physical rest, complete recovery, emotional support, and time are the factors that help women go through 

How Is Recurrent Pregnancy Loss Diagnosed?

Doctors prescribe a diagnosis process for recurrent pregnancy loss post two or more miscarriages. The causes are diagnosed by investigation these following factors:

1. Physical and Fertility related issues:

The doctors check the pelvic for any uterus related issues, the check also includes metabolism and BMI check as they impact the pregnancy hormone levels. Fertility related issues like PCOS and PMOS and thyroid levels impacting pregnancy development are also checked through medical examinations

2. Medical history & supplement audits:

Doctors go through past medical history to cross check habitual abortions, treatment, surgeries or injuries impacting pregnancy. Long term medications mental health, autoimmune disorders, or blood pressure  and over the counter medication consumptions are also audited as they impact the early placenta development.

3. Age and genetics translocations:

Age and genetics are among the major factors of pregnancy loss. Maternal age is linked to the chromosomal abnormalities while the paternal age directly impacts sperm quality. Genetical translocations are also among the common triggers of pregnancy loss.

Scans, past medical reports, blood tests ,last miscarriage samples and genetic tests are the methods used to track these factors that lead to pregnancy loss.

Can Women Have a Healthy Pregnancy After Recurrent Miscarriage?

Yes, women can still have a healthy pregnancy after recurrent pregnancy loss. The treatment starts with identifying the causes and treating them. Depending on the factor type, they are treated with medication, minor surgery, or prescribed lifestyle changes. Here are the steps to prepare for a healthy pregnancy post multiple miscarriages.

• Prescribed doses of folic acid or supplements.
• Maintaining healthy weight and maintaining chronic conditions like diabetes or thyroid
• Abstaining from substance consumption like cigarettes, alcohol, or recreational drugs.
• Seeking emotional and psychological support from professional and dear ones.

In a Nutshell

Recurrent pregnancy loss is among the common issues women face before giving birth to a live child; this issue does not stop one from future births. If you are a pregnant woman undergoing any of the red flag symptoms stated above, reach out to your gynecologist immediately.

If you have gone through recurrent miscarriage and want to seek conception advice, visit the gynaecologist in Ongle. At Orchid Fertility we have advanced fertility equipment and dedicated doctors who provide customised treatment plans.

FAQs

• How to deal with a pregnancy loss?

There is no single fixed way of dealing with pregnancy loss; you need physical rest and to take the prescribed medications for physical healing. Acknowledge your emotions, grieve, and seek emotional support.

• What drinks can cause miscarriage in early pregnancy?

Drinks like alcohol, excess caffeine, and unpasteurized or specific herbal juices increase the chances of miscarriage in the first trimester.

• What are the signs of a healthy pregnancy?

The body undergoes hormonal and physical changes. Some of the early signs of healthy pregnancy include a missed period, tender breasts, and morning sickness.