Tests to take if there is a miscarriage in a row of unknown causes

Article by Dr. Nguyen Thu Hoai – Obstetrics and Gynecology Department – Share99 Times City International Health Hub

Consecutive miscarriages are the phenomenon of having 2 or more consecutive miscarriages, the fetus is removed from the uterus before 22 weeks. In fact, consecutive miscarriages of unknown causes are caused by current medical examinations and tests (in Vietnam or around the world) that have not yet detected the cause.

Many consecutive miscarriages require a lot of tests to find the cause (or exclude possible causes of miscarriage). Along with the progress of medicine, the causes of consecutive miscarriages are finding more and more, especially genetic causes. Tests are divided into the following groups:

1.1 Genetic testing group

• Chroma chroma: Abnormalities of the number or structure of chroma of one or two couples with a history of consecutive miscarriages can be detected. May cause the chrom chroma of the pregnancy to miscarry after the pregnancy is removed from the uterus to find the cause
• Molecular-level genetic testing: Genetic tests ,gene segments associated with miscarriages, abnormal pregnancies. Mother's blood clot gene test increases risk of still pregnancy,miscarriage

1.2 Immune-related testing group

Tests involving blood group disagreements (commonly known as Rh negative), Antipholipid antibody, antiphospholipid antibody, antiCardioLipin antibody, Lupus Anticoagulant antibody, Anti beta 2 Glycoprotein I..

1.3 Micro-testing team assesses infection status

Toxoplasma, CMV, syphilis,…

1.4 Imaging team

Ultrasound: To detect abnormalities in the uterus such as uterine fibroids,malformed uterus, pediatric uterus …, Uterus imaging: detection of malformed uterus, uterus with septum, sticking to the uterus…

1.5 End end of end-of-life tests

Find some endormonal disorders such as diabetes mellitus, thyroiddisease, early fasm depleting …

Treatment as well as patient support for the next pregnancy depending on the cause of consecutive miscarriages

If consecutive miscarriages are caused by genetic abnormalities: Genetic counseling on whether the person should become pregnant again. In case of natural pregnancy: conduct pre-birthdiagnostic tests , amniotic punctures or thorny bios for all pregnancies with parents carrying chromic abnormalities (NST). In in vitro fertilization:conduct a pre-embryonic diagnostic biopsy (PGD technique) to remove embryos carrying genetic abnormalities that cause miscarriage or have a high risk of causing birth defects.

If consecutive miscarriages are caused by antiphospholipid syndrome or carrying the gene for hemulation: treatment with antiaconstaction: Low molecular weight heparin or un-severed Heparin, tingle inhibitors, immunosuppressive drugs or Gammaglobulin as the case may be. Before pregnancy, in cases of Antiphospholipid syndrome with a history of thrombophrosis or second-degree Antiphospholipid syndrome, autoimuscular pathology, patients should be examined and monitored for internal medicine for thrombophrosis or immunosuppressive treatment.

In the case of end end enderthodial deficiency: End end endal support for the patient immediately after the ovule release stage to increase the good nesting capacity of the pregnancy,

Definitive treatment of infection in patients with consecutive miscarriages due to infection

Surgery to treat uterine fibroids, uterine polyps, uterine septum …

Treatment of medotitis, syphilis, renal inflammation or endotry diseases such as thyroidism, basedow…

Since consecutive miscarriages are complex diseases, due to a variety of causes, it is necessary to be diagnosed early and treated early. Therefore, all cases of patients after miscarriage 2 times in a row need to be consulted by obstetrician, especially genetic doctors to detect the specific cause and take early intervention. At the beginning of pregnancy, pregnant women should be managed and monitored closely with obstetrician and gynecologist and coordinating specialties if necessary. The treatment of endococular supplementation, cervical sewing, contraction reduction, treatment of Antiphospholipid syndrome or amniotic puncture tests, thorny biopsies to assess genetic abnormalities will be given by the doctor depending on the cause. At the same time, patients should be consulted and examined and fully tested to detect early signs of thrombosis of the site, signs of pre-cesarean section, delayed pregnancy in the uterus, miscarriage, still pregnancy and signs of side effects of the drug.

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