What We Offer Book Session
Repeated pregnancy losses can be a major source of anxiety to a woman and can even be a reason for loss of esteem.
This condition is becoming increasingly common and despite making great strides, medical science is still not able to provide all answers to this distressing condition.
The causes of repeated pregnancy losses can be manyfold. Most of the time, obstetricians do not advise a battery of tests after the first loss as the abortion is often a result of Nature’s selection process (Nature tries to allow only the best embryos to thrive and embryos which are suboptimal are rejected ....meaning thrown out by the process of abortion).
For any early embryo to survive and grow in the uterus, the first step after fertilization is implantation i.e. the baby latches on to the inner lining of the uterus. Early in the second month of pregnancy, an organ called placenta starts forming. The placenta is a collection of blood vessels and the blood flows from the uterus, via the placenta to the fetus through the umbilical cord. The hormone progesterone plays an important part in the maintenance of the pregnancy in the earlier stages till the placenta is completely formed (usually by the end of the 3rd month).
Abortion may occur early in pregnancy as a result of defective implantation if an insult occurs at that early stage (usually just before or about the time of expected menses); or from defective placentation wherein it may not receive enough blood supply and is therefore aborted.
The entire mystery of why some embryos (even if normal) fail to implant or secure adequate blood supply is as yet ill understood.
The known causes of early pregnancy loss include :
- Infections ... certain viral and bacterial infections.
- Immunological cause ... Antibodies against the placenta which can damage it and decrease blood flow to the fetus e.g. endometriosis
- Genetic defects of the embryo ...often a result of advanced age of the mother or some hereditary diseases or more often, a matter of chance during cell division which occurs after fertilization.
- Certain insults like drugs, radiation or chemotherapy.
- A condition known as thrombophilia in which the woman has a tendency to form blood clots in her vessels leading to blockade of blood supply to the placenta.
- Anatomical defects of the uterus e.g. a septum in the uterus or double uterine cavity or a fibroid in the uterine cavity.
- Endocrine (hormonal) causes ..... These include :
- Luteal phase defect ... which means lack of sufficient hormone progesterone in the early stages of pregnancy.
- Polycystic ovaries
- Hypothyroidism
- Diabetes mellitus
Each of the above factors adversely affects the fetal nourishment by different mechanisms. Some of these conditions e.g. hypothyroidism and diabetes are treatable, and others like genetic defects are not. The couple needs to be investigated in detail and depending on the results, treatment may be instituted.
Whatever be the cause, there are certain common lines of treatment which are recommended to prevent early pregnancy loss. These include oral folic acid supplementation, supportive treatment to the pregnancy using progesterone (oral or vaginal) or Inj HCG and rest (physical and emotional). A lot of other empirical treatments are being used, however their efficacy is controversial and needs to be evaluated further.
What we offer at GyneGuide
Group counselling sessions with Dr Suman Bijlani for an hour followed by Q & A session, which would cover the following issues:
- Introduction and basics
- Causes of recurrent pregnancy loss and a detailed explanation of the same
- Investigations and what they mean
- Treatment of the various causes
- Understanding the first trimester sonography report
Individual counselling for patients with prior appointment.