Encyclopedia of Recurrent Abortions

DEFINITION

Recurrent or habitual abortions is the occurrence of repeated [3 or more consecutive] pregnancies that end in miscarriage of foetus usually before 20 weeks of gestation period.

CAUSES

General

· Infection---
a) Syphilis
b) Toxoplasmosis
· Metabolic diseases--
Diabetes mellitus
· Renal diseases---
a) Chronic renal failure
b) Chronic pyelonephritis [bacterial infection of kidney]
· Endocrinal diseases--Hypothyroidism
· Nutritional deficiencies---
a) Folic acid
b) Vitamins
c) Multiple dietary

Local

Ovaries---
Corpus luteum deficiency
· Uterus ---
a) Congenital malformation
b) Cervical incompetence
c) Displacement--
i. Utero-vaginal prolapsed
ii. Retroversion [tilted uterus]
d) Neoplasm
e) Myomas [fibroids]

Foetus

a) Genetic and chromosomal anomalies
b) Foetus asphyxia [extreme decrease in concentration of oxygen in body] --
i. Essential hypertension
ii. Chronic renal failure
iii. Pre-eclampsia [hypertension arises in pregnancy]
iv. Syphilis
c) Maternal asphyxia ---
i. Congestive cardiac failure
ii. Gross anaemia

INVESTIGATION

Non pregnant women
· Blood---
a) Haemoglobin %
b) Type of anaemia
c) Total differtial leucocytes counts
d) Sedimentation rate [E.S.R.]
. Urine---
a) Glycosuria [excretion of glucose in urine]
b) Pus cells and casts
c) Culture and sensitivity
· X-ray---
a) Chest
b) Hystero-salpigography [HSG of uterus and fallopian tubes]
· Special investigations---
a) Wassermann reaction Kahn's [VDRL]
b) Sabis Feldman and compliment fixation test for Toxoplasmosis
c) Glucose tolerance test
d) Renal function tests
e) Thyroid function test
f) Blood grouping A, B, O and Rh+ and Rh-
g) Anti body
h) Karyotyping [profile of a person's chromosomes]

In pregnant women
· Repeated hormonal tests
· Cervical mucus test---
a) Feming test
b) Spin-barkut test
· Vaginal cytology---
a) Maturation index
b) Urinary oestriol level

TREATMENT

· Treatment is to be directed accordingly
· IVF with pre implantation genetic diagnosis
· Close surveillance during pregnancy

BY

GEETA JHA [SPIRITUAL HEALER]

INDIA