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What Causes A Miscarriage?

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Posted on Tue, 21 Oct 2014
Question: I HAD A LOW RISK GREAT 12W SCAN STONG HEART BEAT AND HARMONY TEST LOW RISK. AT 13W I STARTED BLEEDNG AND CRAMPING. WENT TO HOSPITAL THE BABY HAD DIED AT 12W2DAYS. THE SONOGRAPHER SAID EVERYTING LOOKED STRUCTURALLY PERFECT ONLY NO HEART BEAT. I CANT UNDERSTAND HOW THIS HAPPENED. WHAT ARE THE POSSIBLE REASONS. I WAS ON BABY ASPIRIN AND HEPARIN INJECTIONS TWICE A DAY DUE TO 9 OTHER LOSSES.
doctor
Answered by Dr. Rahul Tawde (5 hours later)
Brief Answer:
Detailed answer below

Detailed Answer:
I am very sorry to learn the misfortune of yours.

However, recurrent early pregnancy loss may be due many reasons, of which majority remains unexplained despite extensive investigations and thorough evaluations. Among the causes, thrombophilia, particularly, anti-phospholipid syndrome plays a major role. Chromosomal abnormalities, infection, anatomic abnormality, autoimmune disorders often play role. Your consultant might also have suspected thrombophilia from your bad obstetric history and for that you were prescribed the medications you mentioned.

Right now, you need a battery of tests to evaluate the underlying cause under a gynaecologists supervision, before trying for another pregnancy.
You may need the following tests-
karyotype of you and your husband
HSG
sonohysterography
Blood for complete blood count, fasting TSH, fasting sugar, HbA1c, serum prolactin level, LH, FSH, antithyroid antibodies, Anticardiolipin antibody levels (IgG and IgM), Lupus anticoagulant, Homocysteine, factor V Leiden, prothrombin promoter mutation, activated protein C resistance.

Regarding the fetal cardiac activity, I would like to say that this is the early sign of fetal demise. This is obvious before you have abortion. So, please consult a local gynaecologist at the earliest.

For any further help, please write back or else you can close the thread and rate my answer.
Regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Rahul Tawde (14 hours later)
Hi thankyou for your response. I have undergone the tests you have mentioned low protein c coming up and secondary antiphosfolipid hence the aspirin and heparin. I had a d&c and that will be tested for chromosomal issues. I just can't understand how there can can be a strong hb one day then it stops a few days later when sonographer said structurally everything seemed perfect just no heart beat
doctor
Answered by Dr. Rahul Tawde (4 hours later)
Brief Answer:
Possible cause is thrombophilia

Detailed Answer:
Thanks for your prompt reply.
As you have already been diagnosed with some form of thrombophilia, the reason for recurrent abortion becomes obvious.
Regarding the heart beat, I would say that finding good fetal heart beat in one scan means your fetus is not at stress at that point of time only. But, a fetal distress for only few hours can be detrimental for its survival. A decline in fetal heart rate implies that your fetus is having stress and when there is no cardiac activity, it means you have lost your baby in utero. Particularly during the early trimester the fetus remains highly vulnerable to any stress. As you are having thrombophilia, at early pregnancy uterine or placental bleeding can occur at early pregnancy, when even a small amount of such bleeding can be disastrous and that's what happened to your baby. Now, I think you have understood the reason behind the unfortunate event that happened to you.
If you find this answer helpful, please close the thread and rate my answer.
Regards
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Rahul Tawde

General & Family Physician

Practicing since :1980

Answered : 1 Question

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What Causes A Miscarriage?

Brief Answer: Detailed answer below Detailed Answer: I am very sorry to learn the misfortune of yours. However, recurrent early pregnancy loss may be due many reasons, of which majority remains unexplained despite extensive investigations and thorough evaluations. Among the causes, thrombophilia, particularly, anti-phospholipid syndrome plays a major role. Chromosomal abnormalities, infection, anatomic abnormality, autoimmune disorders often play role. Your consultant might also have suspected thrombophilia from your bad obstetric history and for that you were prescribed the medications you mentioned. Right now, you need a battery of tests to evaluate the underlying cause under a gynaecologists supervision, before trying for another pregnancy. You may need the following tests- karyotype of you and your husband HSG sonohysterography Blood for complete blood count, fasting TSH, fasting sugar, HbA1c, serum prolactin level, LH, FSH, antithyroid antibodies, Anticardiolipin antibody levels (IgG and IgM), Lupus anticoagulant, Homocysteine, factor V Leiden, prothrombin promoter mutation, activated protein C resistance. Regarding the fetal cardiac activity, I would like to say that this is the early sign of fetal demise. This is obvious before you have abortion. So, please consult a local gynaecologist at the earliest. For any further help, please write back or else you can close the thread and rate my answer. Regards.