Recurrent miscarriage is an overwhelming shock for those who deeply desire to have children. It not only affects a woman’s physical health but also has a significant negative impact on her psychological well-being.
What is recurrent miscarriage?
Miscarriage is the loss of a pregnancy before 20 weeks of gestation and is relatively common, occurring in about 10–15% of pregnancies. In many cases, women may not even realize they have miscarried. Approximately 1% of women experience recurrent miscarriage.
Recurrent miscarriage is defined as two or more consecutive spontaneous pregnancy losses and is classified into two groups:
- Primary recurrent miscarriage: when the woman has never had a live birth.
- Secondary recurrent miscarriage: when the woman has had at least one successful live birth but subsequently experiences repeated miscarriages.
Signs of miscarriage
Many pregnant women are unaware they have miscarried, as this condition often occurs within the first 12 weeks of pregnancy. It is important to pay attention to the following symptoms:
- Abnormal vaginal bleeding during pregnancy
- Severe abdominal pain and cramping
- High fever
- General weakness, muscle pain, and backache
- Persistent lower abdominal pain or contractions
- Pinkish vaginal discharge or blood clots
- Loss of pregnancy-related symptoms such as nausea, vomiting, or food cravings (e.g., sour foods)
If you experience any of the above symptoms, you should contact an obstetrician and visit a reputable medical facility for prompt examination. Register for specialist consultation through the form below.
Causes of recurrent miscarriage
There are many possible causes of recurrent miscarriage. Common ones include:
- Chromosomal abnormalities: Up to 90% of recurrent miscarriage cases are linked to chromosomal abnormalities. These may originate from the father, the mother, or both, leading to extra or missing chromosomes. As a result, the embryo cannot continue developing after fertilization.
- Uterine abnormalities: Structural issues such as uterine malformations, septate uterus, unicornuate uterus, or cervical insufficiency can prevent normal implantation and development of the embryo.
- Immune factors: Autoimmune disorders such as antiphospholipid syndrome may impair blood and nutrient supply to the fetus, preventing proper growth.
- Hormonal abnormalities: Progesterone is essential for supporting pregnancy. In cases of luteal phase defect, insufficient progesterone production prevents the embryo from developing. Women with polycystic ovary syndrome (PCOS) also face a higher risk of recurrent miscarriage.
- Infections: Maternal infections during pregnancy, such as rubella or sexually transmitted diseases (syphilis, gonorrhea, etc.), may damage the pregnancy through bacterial or viral attack.
- Chronic medical conditions: Diseases such as diabetes, hypertension, thyroid disorders, or cardiovascular disease can negatively impact fetal development and increase miscarriage risk.
- Abnormal sperm: Sperm with genetic defects may fertilize an egg but lead to embryos that cannot develop normally, or cause congenital abnormalities requiring termination.
- External factors: Stress, smoking, alcohol consumption, or living in polluted environments with exposure to toxic chemicals (e.g., arsenic, pesticides) also increase miscarriage risk.
- Unknown causes: In about 75% of recurrent miscarriage cases, the exact cause cannot be identified. However, women should not lose hope — with good health and younger maternal age, the chance of achieving a successful pregnancy in subsequent attempts remains around 50–60%.
High-risk groups for recurrent miscarriage
Recurrent miscarriage can occur in many women, but the risk is higher in the following groups:
- History of miscarriage: Women who have had a miscarriage before are at significantly higher risk of experiencing recurrent miscarriage compared to those who have never miscarried.
- Advanced maternal age: Pregnancy after age 35 carries a higher risk. Even if a woman has given birth successfully before, secondary recurrent miscarriage may occur after this age.
- Unhealthy lifestyle: Use of alcohol, tobacco, or other stimulants during pregnancy greatly increases the risk of miscarriage and may lead to recurrent pregnancy loss.
- Poor nutrition: Inadequate maternal nutrition during pregnancy can cause recurrent miscarriage due to insufficient nutrients for fetal development. In particular, deficiencies in vitamin D and vitamin B are strongly linked to an increased risk.
How is recurrent miscarriage treated?
Treatment depends on the underlying cause. Physicians will recommend the most appropriate method for each patient to optimize the chances of a healthy pregnancy in the future.
- Hormonal deficiency: Women should receive hormonal supplementation (e.g., progesterone) as soon as pregnancy is confirmed.
- Cervical insufficiency: Cervical cerclage (stitching the cervix) in the next pregnancy is considered the best preventive measure.
- Infections or chronic medical conditions: These should be treated and stabilized before conception. Women should consult their doctor to ensure that their condition will not negatively affect future pregnancies.
- Chromosomal abnormalities: Couples with genetic issues should seek genetic counseling to discuss risks and determine whether future pregnancies are advisable, as the likelihood of miscarriage remains high.
The best approach is for women who have experienced even one miscarriage to seek medical evaluation and counseling before attempting to conceive again, as the risk of recurrence is significantly higher.
How to prevent recurrent miscarriage?
To minimize the risk of miscarriage and recurrent pregnancy loss, expectant mothers should follow these recommendations:
- Preconception check-up: Have a thorough health evaluation before pregnancy to detect and treat any underlying conditions that may increase the risk of complications.
- Balanced nutrition: During pregnancy, ensure adequate intake of protein, vitamins, and minerals, with plenty of fruits and vegetables, as nutrition is essential for both mother and baby. Poor diet may deprive the fetus of necessary nutrients for growth.
- Regular prenatal check-ups: Routine visits help detect abnormalities early and allow timely intervention. Each check-up also provides guidance on diet, exercise, and safe lifestyle habits for a healthy pregnancy.
- If you have a history of miscarriage: Consult a doctor before planning the next pregnancy.
- Avoid harmful substances: Strictly avoid alcohol, smoking, and secondhand smoke, as these toxins pose serious risks to the fetus.
- Maintain psychological well-being: Stay relaxed and manage stress, since mental health has a significant impact on pregnancy outcomes.
- Adequate rest: Balance work and rest, prioritize sleep and relaxation to support maternal health.
- Seek immediate medical attention for any abnormal signs: Never ignore unusual symptoms during pregnancy, even if they seem minor.
Wishing you a safe and healthy pregnancy, so you can fully enjoy the happiness of holding your healthy baby in your arms.
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Note: The information provided in this article by Hong Ngoc General Hospital is for reference only and is not a substitute for medical diagnosis or treatment. Patients should not self-medicate. For an accurate diagnosis and appropriate treatment plan, please visit a hospital for direct examination and consultation with a physician.
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