Taken from Tommy’s webpage- they are a charity that support couples through stillbirth, premature death and Miscarriage.

Details can be found at the end of the post.

Having one miscarriage can be devastating enough, but having one after another is often a very traumatic experience, I should know. The very thought of trying again can feel like it’s not worth it. Pregnancies will be full of hope but also tinged with a high level of anxiety and fear. Investigations into a possible reason for Recurrent Miscarriage is advisable after the third recurrent miscarriage. You can contact your doctor or you local Early Pregnancy Unit.

There are many possible causes for recurrent miscarriage, including: genetic and hormonal problems; infection and thrombophilic (blood-clotting) defects; uterine problems and cervical weakness. Unfortunately, even after investigation, it’s not always possible for doctors to identify the cause for recurrent miscarriage. However, most couples who have had recurrent miscarriage have a good chance of having a baby in the future.

Where possible, couples should be referred to a specialist unit dedicated to managing recurrent miscarriage.Often good supportive antenatal care in these circumstances makes a big difference; there is some evidence that attending an early pregnancy unit can reduce the risk of further miscarriages.

Causes of recurrent miscarriage

Genetic: In a small number of cases, one partner may repeatedly pass on an abnormal chromosome, causing recurrent miscarriage.Both you and your partner should be offered a blood test to check for chromosomal abnormalities (known as karyotyping). If the tests show a problem, you should be referred to a clinical geneticist for further testing.

Hormonal: In some rare cases an imbalance in pregnancy hormones can lead to conditions such as polycystic ovaries, multiple cysts on a woman’s ovaries caused by high levels of LH (luteinising hormone) and testosterone, which can cause miscarriage. Healthcare professionals can discuss the pros and cons of medical treatment for this.

Blood clotting disorders: Some blood clotting disorders, such as systemic lupus erythematosus and antiphospholipid syndrome can cause ‘sticky blood’ and recurrent miscarriage. These rare disorders of the immune system affect the flow of blood to the placenta and may cause clots that prevent the placenta from functioning properly, depriving the baby of essential oxygen and nutrients, which may lead to miscarriage. Treatment may involve taking aspirin and/or heparin therapy, which both help to thin the blood (research shows that in women who have recurrent miscarriage, their blood has an increased tendency to clot, blocking the flow of nutrients to the baby).

Uterine problems: An abnormally shaped womb can increase your risk of recurrent miscarriage and premature birth. There are a number of ways to investigate the shape of the uterus and depending on the findings, surgery may be recommended.

Cervical weakness: If you are considered at risk of cervical incompetence or cervical weakness, you may be offered a scan or be advised to have stitch or cervical cerclage early in the pregnancy.

Plan of care after recurrent miscarriages

Following recurrent miscarriages, you will usually be offered certain blood tests and a scan to try to identify the problem. Where possible, you will be referred to a specialist unit dedicated to managing recurrent miscarriage. Often, good supportive antenatal care in these circumstances makes a big difference; there is some evidence that attending an early pregnancy unit can reduce the risk of further miscarriages.

Blood tests: Blood tests may be used to check for complications, such as blood clotting disorders; polycystic ovaries and high levels of certain antibodies that can interfere with the pregnancy by affecting the placental blood supply or causing abnormal placental attachment in the womb.

Uterine investigations: An abnormally shaped womb can increase your risk of recurrent miscarriage and premature birth. There are a number of ways to investigate the shape of the uterus and depending on the findings, surgery may be recommended.

Tests and treatments

Expectant management

This is when you wait for any tissue left inside your womb to pass naturally out of it. Find out more about expectant management.

Unfortunately, even after investigation, it’s not always possible for doctors to identify the cause for recurrent miscarriage. Many couples go on to have children with no explanation or past miscarriages.

When a miscarriage happens the medical help around us will often use medical terms which can seem impersonal and unsympathetic,here are some of the terms you may hear around you and what they mean.

Medical management

A woman takes medication and this encourages the pregnancy tissue to pass out of your womb. Learn about what is involved with medical management.

Surgical management

When the tissue is surgically removed. Also known as ERPC. Find out why surgical management may be advised.

ERPC (Evacuation of Retained Products of Conception)

Small operation to remove any tissue that is left inside your uterus (womb) after a miscarriage. This is another term for surgical management.

Pessary

Medication inserted into your vagina.

Placebo

Placebos are designed so that they cannot be told apart from a real drug or treatment, while having no medical effect. This allows scientists to see if a drug really makes a difference to a condition. Sometimes, simply thinking that you are taking medication can make you feel better – the placebo effect. So, if a drug really works, it should be more effective than taking a placebo.

Early Pregnancy Unit (EPU)

This is the unit you’ll be referred to if you have any concerns during early pregnancy.

Recurrent Miscarriage Clinic (RMC)

Your GP will refer you here if you have experienced multiple miscarriages.

Early Pregnancy Unit (EPU)

This is the unit you’ll be referred to if you are having a miscarriage.

Ultrasound scan (or Sonogram)

High-frequency sound waves create an image of inside your body, for example the womb. It can be used to monitor a baby, make a diagnosis or help a surgeon during an operation. An external ultrasound uses an instrument (probe) which moves over the outside of your body to detect the sound waves. An internal ultrasound is when the probe is placed inside your body, for example the vagina, which is known as a Transvaginal scan (TVS).

Cervical stitch

A weakened cervix can be treated with a small stitch to keep it closed. This is usually done after 12 weeks of pregnancy and taken out around 37 weeks.

Other useful terms

Antibody

Antibodies are produced by your immune system as a way to fight disease and infections. They attach themselves to a foreign antigen, such as bacteria or viruses, and weaken or destroy it.

Antiphospholipid syndrome (also known as Hughes’s syndrome, Sticky bloody syndrome, APS)

A condition that causes blood clots , which can prevent the placenta from developing properly. Find out more about antiphospholipid syndrome.

Blighted ovum (anembryonic pregnancy)

Cells stop growing early on and, instead of developing into a baby, the tiny embryo is reabsorbed. The pregnancy sac, where the baby should have grown, sometimes continues to develop.

Cervix

The cervix is tissue that connects the vagina and the uterus (womb).

Chromosome

Used as building blocks in a baby’s development, these rod-shaped structures (usually found in pairs in a cell nucleus) carry the genes. These genes determine the sex of the baby and the characteristics a baby inherits from its parents. A human body cell usually contains 46 chromosomes arranged in 23 pairs (23 from the mother and 23 from the father).

Chromosomal abnormalities

If a baby carries too many or not enough chromosomes, it won’t develop properly.

Hormone

A chemical secreted by an endocrine gland or some nerve cells. Hormones travel to different parts of the body where they help regulate and control how cells and organs do their work.

Lupus anticoagulant

An antibody to phospholipids in a cell that can cause clotting of blood in arteries and veins and lead to early miscarriage.

Post-Traumatic Stress Disorder

A psychological condition affecting people who have suffered severe emotional trauma causing sleep disturbances, flashbacks, anxiety, tiredness, and depression.

Stem cell

Special cells made by the body that can turn into many other types of cell.

Rhesus disease

A condition where antibodies in the mother’s body destroy her baby’s blood cells.

If you have any questions please contact your GP, local midwife or EPU.

This information was taken from Tommy's webpage, Tommy's is a charity that fund research into miscarriage, stillbirth and premature birth, and provide pregnancy health information to parents. They believe it is unacceptable that one in four women lose a baby during pregnancy and birth. They want every parent to have the best possible pregnancy outcomes and to take home happy, healthy babies.

There pages are very useful for anyone who is or has suffered the lost of a child due to miscarriage, still birth or premature birth.

www.tommys.org