What is Counseling for Recurrent Pregnancy Loss? How come?

Recurrent pregnancy loss is defined as three or more consecutive pregnancy losses. This situation; It may be caused by various reasons such as physical, genetic, hormonal and environmental factors. For women experiencing recurrent pregnancy loss, appropriate counseling and treatment is important to identify underlying causes and achieve the healthiest pregnancy possible. In this article, we have compiled what you need to know about counseling in recurrent pregnancy loss.

How to Provide Counseling for Recurrent Pregnancy Loss?

We can list the steps of recurrent pregnancy loss counseling as follows:

• Specialist Obstetrician, Perinatologist or infertility specialist: These specialists investigate the causes of recurrent pregnancy loss. They may decide to investigate the patient’s history and characteristics after three or three miscarriages.

• Detailed Medical History and Evaluation: The specialist doctor will carefully evaluate the expectant mother’s medical history and previous pregnancy losses. Risk factors such as family history, chronic diseases, infections and genetic predisposition will be taken into consideration.

• Physical Examination: The expectant mother will undergo a physical examination. This examination aims to evaluate the reproductive organs and other body systems.

• Blood Tests: Various blood tests are performed, including hormonal levels and thyroid function.

• Genetic Tests: The specialist doctor may recommend the necessary genetic tests to evaluate genetic predisposition.

• Ultrasonography: Gynecological examination and vaginal ultrasound are performed for a detailed evaluation of the uterus and ovaries.

• Special Tests: The specialist doctor may recommend some special tests to evaluate the structure and function of the reproductive organs. These tests may include methods such as hysterosalpingography (HSG), sonohysterography and laparoscopy.

• Treatment Plan: Based on the data obtained as a result of evaluations and tests, the specialist doctor will create a treatment plan. This treatment plan may vary depending on the underlying causes and may include hormonal medications, thyroid medications, surgical interventions, genetic counseling, and supportive treatments.

Expectant mothers who experience recurrent pregnancy loss can work with psychologists or counselors to receive emotional and psychological support during this process. Emotional health is also very important during a healthy pregnancy.

Of course, every situation is individual and the treatment process is specific to the person. Therefore, it is important to create an optimal treatment plan by consulting with an obstetrician or reproductive endocrinologist and having all necessary tests done.

What are the causes of Recurrent Pregnancy Loss?

1. Anatomical causes: Developmental or later anatomical reasons in the uterus may cause recurrent pregnancy loss. Examples of congenital anomalies include semi-developed uterus (uterus unicornis), uterine septum (uterine septum) and cervical insufficiency. Examples of acquired ones are synechiae (adhesive), which may occur after abortions, Asherman syndrome (damage to the inner layer of the uterus) and cervical insufficiency (cervical insufficiency).

2. Genetic reasons: Genetic disease carriers in the expectant parents cause defective development of the embryo and are a common cause of first trimester losses. Chromosomal translocation carriers can be given as an example. Another important example is consanguineous marriages. The risk of rare single gene diseases increases in consanguineous marriages.

3. Endocrine causes: Endocrinological diseases caused by some hormonal disorders, especially in the expectant mother, may cause recurrent pregnancy loss. The two most important examples are diabetes and conditions in which thyroid gland hormone synthesis is insufficient.

4. Infectious causes: Although infectious diseases usually cause one-time miscarriage, they are a rare cause of recurrent pregnancy loss.

5. Immunological causes: Some acquired specific diseases can cause recurrent pregnancy loss. Chief among these is a special disease known as APS (antiphospholipid antibody syndrome). It is a disease that must be investigated in cases of recurrent pregnancy loss.

6. LFD (Luetal Phase Failure): It is a condition that occurs with insufficient production of progesterone hormone, which ensures the continuation of pregnancy from the onset of pregnancy until the 14th week. It must definitely be treated.

7. Clotting disorders: Actually, this is a very rare cause, but it should still be examined in detail.

8. Idiopathic: This is the term used when the cause cannot be determined. Even if all tests are performed for recurrent pregnancy losses, the cause cannot be found in approximately half of them.

To summarize: recurrent pregnancy losses can be caused by a very specific group of diseases. A very detailed and meticulous research needs to be done. The most important point is that once the cause is explained, treatment is planned accordingly. In other words, it should not be forgotten that dangerous medications such as blood thinners will not be used in every miscarriage.