Dr. Manasi Thakur | Gynaecologist In Nagpur | Pregnancy, Delivery | Abortion | Cosmetic Gynecology
What is Recurrent Miscarriage?
Recurrent miscarriage is defined as the occurrence of three or more consecutive spontaneous abortions before 20 weeks of pregnancy. Some experts, however, consider two or more consecutive losses as the standard. It can be:
Primary: No previous viable birth.
Secondary: Occurs after having at least one previous viable birth.
This condition affects approximately 1% of all women of reproductive age. The risk increases with each successive miscarriage, reaching over 30% after three consecutive losses.
Causes of Recurrent Miscarriage
Several factors may contribute to recurrent miscarriage:
Genetic factors (3–5%): Parental chromosomal abnormalities are a proven cause.
Metabolic disorders: Poorly controlled diabetes increases the risk of early pregnancy loss.
PCOS: Polycystic ovarian syndrome is also a recognized cause.
Infections: Syphilis, toxoplasmosis, and listeriosis may lead to miscarriage. Transplacental fetal infection is also possible.
Autoimmune factors (15%): Autoantibodies such as antinuclear antibodies, anti-DNA antibodies, and antiphospholipid antibodies may cause pregnancy rejection, especially in the second trimester.
Anatomical abnormalities: Intrauterine adhesions, uterine fibroids, endometriosis, and cervical incompetence.
Diagnosis at Dr. Manasi Thakur, Zenith Hospital, Nagpur
At Zenith Hospital, Dr. Manasi Thakur performs a thorough medical, surgical, and obstetric evaluation to identify potential causes.
The process includes:
Detailed history of previous miscarriages and chronic illnesses.
Blood investigations: Blood sugar, VDRL, thyroid function tests, ABO and Rh grouping (both partners), and antibody screening.
Ultrasonography: To detect uterine abnormalities, PCOS, or fibroids.
Hysterosalpingography, hysteroscopy, and laparoscopy for structural evaluation.
Karyotyping (husband and wife): To detect chromosomal abnormalities.
Endocervical swab: To rule out chlamydia, mycoplasma, and bacterial vaginosis.
Management & Treatment of Recurrent Miscarriage in Nagpur
The treatment plan depends on the identified cause:
Genetic causes: Genetic counselling for couples with chromosomal abnormalities.
PCOS: Treatment of insulin resistance, hyperinsulinemia, and hyperandrogenemia. Metformin therapy may be helpful.
Infections: Treated appropriately after culture and sensitivity tests.
Monitoring pregnancy: Early ultrasonography to confirm viability. If the fetus is viable at 8–9 weeks, only 2–3% risk of loss remains, and after 16 weeks, the risk drops to just 1%.
Supportive care: Adequate rest, avoiding strenuous activities, sexual intercourse, and traveling during early pregnancy.
Despite all available investigations, 40–60% of recurrent miscarriages remain unexplained. However, “tender loving care” (TLC) and supportive therapy have been shown to improve pregnancy outcomes by up to 70%.
In many cases, miscarriage may result from poor blood supply, inflammation, or immune system dysfunction. Importantly, as Dr. Manasi Thakur confirms, experiencing a miscarriage does not reduce the chances of future pregnancy. In fact, many women conceive successfully afterward.