Recurrent Pregnancy Loss

Recurrent pregnancy loss (RPL), recurrent abortion, or habitual abortion are all names for the same medical condition. The formal definition is three consecutive pregnancy losses (miscarriages). This is an uncommon problem affecting less than 1% of the population, but when it occurs it is emotionally devastating. Even when this occurs, the chance of a successful pregnancy is 50%. Many women prefer to initiate testing after having two consecutive pregnancy losses; this affects approximately 5% of the population.

Since 50% of pregnancies will be successful be no matter what is done. Studying treatments for this can be very difficult. Specifically, if a woman is told that simply rubbing her belly and tapping her head three times before she goes to bed is a treatment for RPL, it will work half the time. And if a woman has gone through losing three pregnancies, and has a successful pregnancy by doing the belly rub/head tap, she will swear by it.

There are proven problems that cause RPL and other problems that have been proved not to cause RPL. The most common cause of RPL is that there was something wrong with the egg or sperm before they got together to make an embryo. This is a haphazard event that is more likely to occur with age.

There are recognized causes of RPL. Medical conditions can lead to RPL, such as diabetes, thyroid disease, polycystic ovarian syndrome and autoimmune diseases. Smokers have a miscarriage rate nearly twice high as non smokers.

Structural abnormalities of the uterus such as a uterine septum or fibroids are proven causes of RPL. These are readily diagnosed with sonography performed by a qualified gynecologist.

Another proven cause of RPL is a disease process referred as thrombophilia. “Thrombo” means “clot” and “philia” means “love to.” With this disease process, the blood flowing through the placenta can clot and cut off the oxygen supply to the developing embryo. This can also occur later in pregnancy and lead to a stillbirth at term. These pregnancies require special medications and monitoring throughout the pregnancy to ensure a healthy delivery.

A very common belief is that progesterone treatment can improve pregnancy outcomes, but this is not true. Although progesterone treatment can delay vaginal bleeding in early pregnancy, it does not alter miscarriage rates.

Alliance Ob/Gyn has a great deal of experience with the diagnosis and treatment of RPL.