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I, too, am allowed to grieve- What you need to know about miscarriages

Living

Any chronic and untreated conditions can contribute to poor pregnancy outcomes, including miscarriages. However, once a chronic condition has been stabilised, and there is no medical reason to avoid conceiving, the pregnancy should progress normally with additional appropriate monitoring. This is according to Dr Alfred Murage, Consultant Gynecologist and Fertility Specialist at the Harley Street Fertility Centre.

“In the case of Mercy, having had a heart problem at a young age, and this having been since corrected, should not directly cause a miscarriage. The best strategy would have been to do a detailed review of the prevailing circumstances, as it is still very likely the cause was chromosomal,” says Murage.

Reliable statistics aren’t readily available locally as many miscarriages go unreported and aren’t captured in health databases.

“Older women, mostly in late 30s and above, have higher risks of miscarriages as chromosomal abnormalities tend to rise with age,” says the expert.

He adds that most miscarriages occur due to chromosomal (genetic) abnormalities in the developing embryo, which tends to be a random event and it isn’t recurrent.

“Those with recurrent miscarriages (defined as 2 or more consecutively), may have a condition called anti-phospholipid syndrome (APS). This justifies testing anyone categorised as having recurrent miscarriages. Uncommon causes include structural abnormalities within the uterus, and existing genetic conditions in either one or both parents. Some miscarriages will not have a known cause even after extensive testing. Such situations are referred to as ‘unexplained’ and are difficult to treat.”

Women with thrombophilia (an abnormal tendency to develop blood clots) and recurrent miscarriage have high chances of successful pregnancy if treated with blood thinning injections and aspirin throughout their subsequent pregnancies. Some uterine abnormalities can be surgically corrected.

If the parents have a chromosomal abnormality, the only remedy is undergoing assisted conception techniques and selecting unaffected fertilized eggs (a technique called Pre-implantation Genetic Diagnosis (PGD).

Many women who have suffered a miscarriage often wonder how soon they can conceive again.

“If any factors responsible have been identified, these should be addressed as appropriate and remedial measures put in place with the next planned conception. Most women can conceive as soon as they feel ready following both psychological and physical recovery after the miscarriage,” explains Dr Murage.

According to the expert, several measures can be taken to reduce the risk of suffering a miscarriage.

“Chromosomal causes are random for young people; hence not much can be done to prevent this. Planning to complete a family prior to advanced age helps. Those diagnosed with specific causes will be put on appropriate remedies. Conceiving when in optimal health and avoiding toxins like smoking, drugs, alcohol are also good strategies to optimize pregnancy outcomes,” he says.

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