Miscarriage (cont.)

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Can something be done to prevent future miscarriages?

The treatment of recurrent miscarriage depends on what is believed to be the underlying cause. This often is not as simple as it sounds. Careful evaluation may turn up several potential factors which alone or together may be responsible for the pregnancy losses. If a chromosomal problem is found in one or both persons, then counseling as to future risks is the only option for the couple, since there is currently no method to correct genetic problems.

If a structural problem is encountered with the uterus, surgical correction could be contemplated. It should be emphasized that just because a structural abnormality is found, it does not necessarily mean that it caused the miscarriage. Removal of a fibroid or uterine septum does not guarantee a future successful pregnancy, since the fibroid or uterine septum may not have been the cause of miscarriage in the first place.

Adequate control of diabetes and thyroid disease is critical in trying to prevent recurrent pregnancy loss in women with those conditions. For women with immunologic problems, such as such as systemic lupus erythematosus and antiphospholipid antibody syndrome, certain medications are being studied that may be useful in achieving successful pregnancy outcomes. Blood thinners such as aspirin and heparin can, in some cases, prevent further pregnancy loss.

The use of progesterone to increase the blood levels of this hormone is sometimes used for patients with recurrent pregnancy loss, although large-scale controlled studies that confirm the utility of progesterone supplementation have not been carried out. However, many physicians report success with progesterone therapy. Progesterone may be given as vaginal suppositories, or in tablet or gel form.

In dealing with recurrent pregnancy loss, it is important to realize that even though apparently obvious problems can be corrected, a miscarriage can still occur. This is not to say that attempts should not be taken to correct identified abnormalities that have been historically associated with miscarriage. However, no treatment can be guaranteed. Even with repeated miscarriages, there is still a very good chance of achieving a successful pregnancy. Early pregnancy and pre-pregnancy counseling can help identify risk factors and allow the practitioner to provide any special care that may be needed.

Medically reviewed by Edmund Petrilli, MD; American Board of Obstetrics and Gynecology with a subspecialty in gynecologic oncology REFERENCE: eMedicine.com. Early pregnancy loss.
<http://emedicine.medscape.com/article/266317-overview>
Recurrent Pregnancy Loss: Etiology, Diagnosis, and Therapy Holly B Ford, MD* and Danny J Schust, MD Rev Obstet Gynecol. 2009 Spring; 2(2): 76–83. Previous contributing medical authors: Leon J. Baginski, MD, FACOG, and Carolyn J. Crandall, MD, FACP


Medically Reviewed by a Doctor on 3/7/2014

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