RPL
Causes of Recurrent Pregnancy Loss
1. Genetic and Chromosomal Factors
- About 50-60% of early miscarriages are due to chromosomal abnormalities in the embryo.
- In some cases, parental chromosomal translocations (where a piece of one chromosome attaches to another) can lead to repeated pregnancy loss.
2. Uterine Abnormalities
- Structural abnormalities like uterine septum, fibroids, adhesions, or an abnormally shaped uterus can hinder implantation and fetal growth.
- Congenital malformations may also contribute to pregnancy loss.
3. Hormonal and Endocrine Disorders
- Thyroid disorders (hypothyroidism or hyperthyroidism) can affect pregnancy viability.
- Luteal phase defects (low progesterone levels) can lead to implantation failure.
Recurrent Pregnancy Loss
Recurrent Pregnancy Loss (RPL) is defined as the loss of two or more consecutive pregnancies before 20 weeks of gestation. It is a distressing condition affecting approximately 1-2% of women trying to conceive. Unlike a single miscarriage, RPL indicates an underlying issue that requires medical evaluation and management.
Treatment and Management of RPL
1. Lifestyle Modifications
- Maintaining a healthy weight, reducing stress, and avoiding smoking/alcohol can improve pregnancy outcomes.
- A balanced diet rich in folic acid and prenatal vitamins is recommended.
2. Medical Interventions
- Hormonal Therapy: Progesterone supplements to support early pregnancy.
- Thyroid and Diabetes Management: Proper treatment for hormonal disorders.
- Blood Thinners: Aspirin or heparin for clotting disorders like APS.
Evaluation of Recurrent Pregnancy Loss
Doctors conduct a thorough evaluation, including:
- Genetic Testing: Karyotyping of both partners to detect chromosomal translocations.
- Hormonal Tests: Thyroid function, prolactin, and glucose tolerance tests.
- Uterine Assessment: Hysterosalpingography (HSG), sonohysterography, or MRI to detect abnormalities.
- Blood Clotting Tests: Screening for antiphospholipid syndrome and thrombophilia.