What is pregnancy loss?
Pregnancy loss is the death of an unborn baby (fetus) at any time during pregnancy. Early pregnancy loss “miscarriage or spontaneous abortion” is pregnancy loss in the first trimester of pregnancy i.e. prior to 13 weeks gestation. It is estimated that 10% of pregnancy loss happens during this period of pregnancy. A stillbirth is defined as a pregnancy loss that occurs after 20 weeks gestation. Stillbirth is one of the most common adverse pregnancy outcomes, occurring in 1 in 160 deliveries in the United States. Approximately 23,600 stillbirths at 20 weeks or greater of gestation are reported annually.
What is recurrent pregnancy loss?
According to the American College of Obstetrician Gynecologists, recurrent pregnancy loss is defined as having two or more miscarriages. After three repeated miscarriages a thorough physical exam and testing are recommended.
What are some common causes for recurrent pregnancy loss?
Many instances of pregnancy loss are thought to occur randomly when an embryo receives an abnormal number of chromosomes during fertilization. However, there are other causes such as congenital abnormalities of the uterus, fibroids, polyps, inherited or acquired thrombophilia’s, autoimmune diseases and unidentifiable causes..
What is unexplained recurrent pregnancy loss?
It is estimated that 50-75% of patients who experience recurrent pregnancy loss will have “unexplained recurrent pregnancy loss.” This means that no specific cause has been identified in the work-up. In these instances there are various treatment options that may be offered to our patients however, there is no universal treatment recommendation. Therefore, we tailor each treatment regimen to each individual patient.
What tests are done for couples who experience recurrent pregnancy loss?
Our physicians will start by conducting a detailed medical, family, surgical and genetic history as well as perform a physical exam. The evaluation may include imaging studies to assess the uterine cavity as well as laboratory studies to consider hormone levels, thyroid function, immune system deficiencies and blood clotting disorders. The evaluation and work-up may also include a recommendation of fetal autopsy; gross and histologic examination of the placenta, umbilical cord, and membranes.
What treatment is available for recurrent pregnancy loss?
Treatment for recurrent pregnancy loss can be multifactorial and is based on underlying cause of recurrent pregnancy loss. If a uterine abnormality is found, surgical intervention may be indicated. If hormone imbalances are identified, hormones may be supplemented. If a thrombophilia is discovered, anticoagulation therapy such as low-dose aspirin or heparin may be administered.