Testing For Multiple Miscarriage
Once Is Happenstance
When a couple discovers they are pregnant, it is one of the most exhilarating experiences ever. The initial prenatal tests indicate all seems well. Then, for reasons unfathomable, the pregnancy is lost. While it is not uncommon for first pregnancies to be lost, when miscarriage occurs more than once, most women want to know why they are miscarrying and what, if anything, can be done to prevent it.
More Than Once Is Cause For Investigation
Usually the cause of a miscarriage is a random genetic problem in the developing baby and there is nothing that can be done to prevent it. However, when two or three miscarriages happen, it is unlikely the cause is chromosomal and it makes good sense for the doctor to order tests, which may reveal a reason why the miscarriages are happening.
Several different tests are commonly used for women with recurrent miscarriages. There continues to be a lot of controversy when it comes to treatment for recurrent miscarriage and there remain some inconclusive thoughts on causes and treatments among the medical community.
To test for uterine problems, the hysterosalpingogram (HSG) is used. This imaging test uses a dye that is injected into the uterus and then an x-ray is taken. The doctor is looking for an abnormal shape to the uterus that may be causing the problem, or perhaps a division within the uterus itself. The hysteroscopy involves the insertion of a thin telescope into the uterus in order to get a better picture of what is going on. It is possible for the doctor to repair minor problems during this test, such as the removal of a small cyst or lesion.
Blood tests that are outside the scope of the usual ones done during prenatal testing may give the doctor a clue as to why the miscarriages are recurrent. Antiphospholipid syndrome (APS) is an autoimmune disorder in which the body's immune system reacts against certain substances that are normally present in the blood. APS creates a situation where a woman may have a greater tendency to form blood clots than a woman without APS does.
APS is linked to higher odds of pregnancy loss. It is estimated that up to 25 percent of women who suffer recurrent miscarriages have APS. Often, no other symptoms of the syndrome are present and the condition is unknown until the testing is done. Two blood tests will reveal APS. Lupus anticoagulant antibodies are one of the markers and another is anticardiolipin antibodies. Both are visible in specific blood tests.
PT (Prothrombin Time) is a test to see how fast the blood clots. aPTT (Activated Partial Thromboplastin Time) is another blood-clotting test. If there are abnormal results on either of these tests, it may indicate hereditary thrombophilias. Thrombophilias are a group of disorders that promote blood clotting, making the blood clot too easily due to too much of certain proteins (blood clotting factors) or too little of anti-clotting proteins that limit clot formation. Thrombolphilias may pose special risks in pregnancy.