Loosing a baby in pregnancy can be a heartbreaking experience and having more than one miscarriage a devastating ordeal. So many times a miscarriage is considered a normal turn of events and we are often told that one in four pregnancies will end in miscarriage; however this is of no real comfort to the parents of the lost child.
Miscarriage is also known as a spontaneous abortion and the correct definition for this is the spontaneous loss of a pregnancy before 20 weeks gestation. This occurs in about 15 percent of pregnancies.
We are slowly coming to recognize that no miscarriage can be considered normal. All miscarriages are the result of an abnormal reproductive event.
In the last 5- 10 years there has been a change in the management of miscarriages, if a couple have had three or more consecutively, there is a thorough investigation completed, to investigate the cause. There is a growing recognition that there appears to be an association between infertility and miscarriage.
Thanks to NaProTECHNOLOGY® we can now asses the cycles that are most at risk for miscarriage and treat each cycle as necessary to prevent such a loss. Our approach to the management of recurrent miscarriage is to search for the underlying problem and treat whatever we find, we consider a miscarriage to be an abnormal event instead of a common natural event.
The CREIGHTON MODEL System (CrMS) can identify unusual bleeding patterns, short luteal phase in the menstrual cycle, a limited mucus cycle and dry cycles, pre-menstrual spotting, a highly variable post-Peak phase and pre-menstrual symptoms, all of which are associated with a Progesterone Deficiency and can cause miscarriage. Other findings include ovulation disorders and endometriosis. Identifying and treating abnormal looking cycles increases the chances of success with treatment.
EVALUATION AND TREATMENT
The initial evaluation is based on the woman’s chart together with a timed blood test to assess for deficiencies of the hormones Progesterone or Oestradiol 17 ß in the luteal phase of the menstrual cycle.
If the results show the hormone levels to be below the normal range, treatment is given to correct the underlying abnormality.
In those lady’s whose hormone profile is completely normal, the recommendation would be for further surgical evaluation of the woman’s uterus (womb) including an endometrial biopsy to check for an infection of the uterus which could cause a miscarriage.
The blood test would also be looking for chromosomal or blood clotting abnormalities or other physical illnesses which are recognised to contribute to recurrent miscarriage.
Environmental and lifestyle factors are often very significant contributors to miscarriage. In particular excessive alcohol and cigarette smoking together with a busy stressful working environment or other lifestyle stress may be the primary reasons why the couple are having miscarriages.
Endometriosis can be a significant cause of recurrent miscarriage for some couples; it can be treated by Pelvic Excision and Repair Surgery which is done laproscopically (keyhole surgery).
Once the couple does conceive we recommend ongoing hormone support during pregnancy with Progesterone and HCG. This is gradually reduced and discontinued depending on the results of Progesterone blood tests taken every two weeks during the early stages of pregnancy.
This treatment is minimally invasive, safe and significantly increases the possibility of a successful pregnancy. Unfortunately not everyone is successful; nearly 80% of couples will eventually achieve pregnancy and couples with a history of 8 to 9 previous miscarriages have been able to have successful pregnancies with this treatment.