Management of Recurrent Abortions/Miscarriages

Recurrent miscarriage, also known as recurrent pregnancy loss (RPL), is defined as the loss of two or more consecutive pregnancies. It is a distressing condition that affects about 1–2% of couples trying to conceive. While early pregnancy loss is often due to chromosomal abnormalities, recurrent miscarriages can result from a variety of underlying causes, including genetic, anatomical, hormonal, immunological, or infectious factors. A thorough and timely evaluation is essential to identify the root cause and plan an effective treatment approach. With the right investigations, medical support, and emotional care, many women with a history of recurrent miscarriages can achieve a healthy and successful pregnancy.

Common Causes of Recurrent Miscarriage

- **Genetic abnormalities**: Chromosomal disorders in either partner
- **Anatomical issues**: Uterine abnormalities such as septum, fibroids, or adhesions
- **Hormonal imbalances**: Thyroid dysfunction, diabetes, or luteal phase defects
- **Blood clotting disorders**: Thrombophilia or antiphospholipid antibody syndrome
- **Infections**: Chronic infections of the uterus or reproductive tract
- **Immune system factors**: Autoimmune conditions that interfere with embryo implantation
- **Lifestyle factors**: Smoking, alcohol, caffeine, obesity, or chronic stress

Investigations for Recurrent Miscarriage

- Karyotyping (genetic testing) of both partners
- Pelvic ultrasound or hysteroscopy to assess uterine structure
- Blood tests for hormonal levels, thyroid function, and blood sugar
- Tests for antiphospholipid antibodies and other clotting disorders
- Infection screening (e.g., TORCH profile)
- Endometrial biopsy in selected cases

Treatment and Management

- **Genetic counseling** and IVF with preimplantation genetic testing (PGT) for chromosomal issues
- **Surgical correction** of uterine anomalies (like septum removal)
- **Hormonal therapy** such as progesterone supplementation in early pregnancy
- **Thyroid or diabetes management** to maintain optimal levels
- **Blood-thinning medications** like aspirin or heparin for clotting disorders
- **Antibiotic therapy** if chronic infections are detected
- **Lifestyle modifications** including stress reduction, healthy diet, and weight management
- **Regular antenatal care and close monitoring** in early pregnancy

Support and Counseling

Emotional support is a crucial part of managing recurrent miscarriages. Counseling services, support groups, and stress management techniques help couples cope with the emotional toll and build hope for future pregnancies. With advancements in medical science and personalized care, many couples with recurrent pregnancy loss can go on to have healthy babies.