Overview

Women over the age of 35 and those who have had previous losses are at a higher risk of recurrent miscarriage. Miscarriage is likely underreported since many women miscarry before they even realize they are pregnant and have no signs or symptoms of the miscarriage. An ultrasound (a diagnostic imaging technology ) can identify and diagnose a miscarriage in the majority of cases. The vast majority of miscarriages are caused by genetic defects in the embryo or fetus such as an extra or missing chromosome. These are usually random mutations that are unlikely to occur again. 

However in the case of recurrent miscarriage the situation is different and the doctor will check for a specific sort of mutation known as a balanced translocation. While it is linked to recurrent miscarriage it is still an extremely rare occurrence. Some women who have miscarriages or recurrent losses feel vaginal bleeding breast discomfort or fullness and fetal movement or sound loss. Clinical pregnancies are distinct from chemical pregnancies in which a miscarriage happens before there is any sign of pregnancy other than a positive pregnancy test or blood test. Miscarriages account for 15 to 20% of all clinical pregnancies.

Causes

As a woman matures her risk of miscarriage because of genetic defects rises from 15 to 20% when she is under the age of 35 to more than 50% when she is over 40. 

• Genetic abnormalities: When an embryo (fertilized egg) obtains an incorrect amount of chromosomes after fertilization a genetic defect occurs. This sort of genetic cause arises by chance and is not related with any medical issue. One partner in a tiny fraction of recurrent miscarriage couples may have chromosome translocation (where one component of a chromosome breaks off and reattaches to a second chromosome). 

• Anatomical anomalies: A septate uterus is a condition in which a tissue wall splits the uterus into two portions and can lead to recurrent miscarriage. While it is unclear why this leads to recurrent miscarriage some providers believe that the embryo stops growing if it implants in the septum due to insufficient vascularity. If the pregnancy is carried to term the fetus could be breech. Fortunately eliminating a uterine septum is usually a simple surgical procedure. 

• A cervix that is incompetent cannot remain closed due to weakening muscles. When the developing fetus reaches a particular weight the weaker cervix can no longer sustain the fetus resulting in miscarriage. 

• Medical condition : Several medical conditions including: Antiphospholipid syndrome (APS) is an autoimmune illness that arises when a person's immune system produces antibodies to molecules that are required for blood clotting by mistake. 

• Thyroid/hormonal imbalances can develop from an overactive or underactive thyroid (endocrine gland at the base of the neck). If the uterine lining does not form normally for implantation and nourishment of a fertilized egg hormonal abnormalities can induce a miscarriage. 

• Elevated prolactin (a reproductive hormone generated by the pituitary gland) levels can interfere with healthy uterine lining growth.

•  Fibroids and polyps are noncancerous growths that can enter and invade the uterus. 

• Asherman's syndrome is a disorder in which scar tissue accumulates inside the uterus and can lead to miscarriage.

Symptoms

Each miscarriage you experience may be unique. One might induce pain and bleeding while another might not. Typical miscarriage symptoms include: 

• Bleeding or spotting 

• Back pain ranging from mild to severe (worse than menstruation cramps) 

• Vaginal discharge of white-pink mucous 

• Contractions (painful contractions that occur every 5 to 20 minutes) 

• Tissue that resembles a clot exiting the vagina 

• A sudden decrease in pregnancy symptoms

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