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Tests to do if you have repeated unexplained miscarriages


Posted by Doctor CKII Nguyen Thu Hoai - Obstetrics Department - Vinmec Times City International Hospital

Consecutive miscarriage is the phenomenon of having 2 or more consecutive miscarriages, the fetus is expelled from the uterus before 22 weeks. In fact, consecutive miscarriages of unknown cause are caused by medical examinations and tests at present (in Vietnam or around the world) that have not yet discovered the cause.

1. What tests should be done for consecutive miscarriages?


Many recurrent miscarriages require a lot of testing to find the cause (or rule out possible causes of miscarriage). With the advancement of medicine, the causes of recurrent miscarriages are increasingly found, especially genetic causes. Tests are divided into the following groups:
1.1 Genetic testing group
Chromosome: Can detect abnormalities in the number or structure of chromosomes in one or two couples with a history of consecutive miscarriages . Can cause fetal chromosomal miscarriage after the fetus is expelled from the uterus to find the cause. The mother's blood clotting gene test increases the risk of stillbirth and miscarriage
Xét nghiệm gen trước khi mang thai
Xét nghiệm gen di truyền

1.2 Immune-related test group
Blood group incompatibility test (commonly Rh negative), Anti-Phospholipid antibody test, antiphospholipid antibody, antiCardioLipin antibody, Lupus Anticoagulant antibody, Anti beta 2 Glycoprotein I ..
1.3 Microbiological testing group to assess infection status
Toxoplasma, CMV, syphilis, ...
1.4 Imaging group
Ultrasound: To detect abnormal cases in the uterus such as tumors uterine fibroids , uterine malformations , uterine malformations..., Hysteroscopy: detecting uterine malformations, septal uterus, uterine adhesions...
1.5 Endocrine tests
Find some endocrine disorders such as diabetes mellitus, thyroid disease, premature luteal insufficiency...
Xét nghiệm axit nucleic (Nucleic Acid Test - NAT)
Xét nghiệm nội tiết giúp tìm ra nguyên nhân sảy thai

2. How to treat recurrent miscarriage?


Treatment as well as support for the patient for the next pregnancy depends on the cause of the consecutive miscarriage
If the consecutive miscarriage is due to a genetic abnormality: Genetic counseling to see if the patient should get pregnant more or not. In case of spontaneous pregnancy: conduct prenatal diagnostic tests, amniocentesis or chorionic villus sampling for all pregnancies in which one parent carries a chromosomal (chromosomal) abnormality. In IVF: Pre-embryonic diagnostic biopsy (PGD technique) is performed to remove embryos carrying genetic abnormalities that cause miscarriage or have a high risk of birth defects.
If recurrent miscarriage due to antiphospholipid syndrome or carrier of hypercoagulable genes: treat with anticoagulants: Low molecular weight heparin or unbroken heparin, platelet inhibitors, immunosuppressants or Gammaglobulin depending on the case. Before pregnancy, with cases of Antiphospholipid syndrome with a history of thrombosis or secondary Antiphospholipid syndrome, autoimmune disease, the patient should be examined and monitored by internal medicine specialist for thromboprophylaxis or suppressive therapy. immunity.
Mô bệnh học cho thấy vi huyết khối đang được hình thành trong hội chứng ALPA
Mô bệnh học cho thấy vi huyết khối đang được hình thành trong hội chứng antiphospholipid

In case of endocrine deficiency: Provide endocrine support to the patient right after ovulation to increase the possibility of good implantation of the fetus,
Complete treatment of infection in patients with miscarriage consecutively due to infection
Surgical treatment of uterine fibroids, uterine polyps, uterine septum...
Treatment of mother's systemic diseases such as diabetes, syphilis, kidney inflammation or other diseases Endocrine disorders such as hypothyroidism, basedow...
Due to consecutive miscarriages is a complicated disease, due to many different causes, it is very important to diagnose the cause and treat it early. Therefore, all cases of patients after 2 consecutive miscarriages should be consulted by an obstetrician, especially a geneticist, to detect specific causes and take early intervention measures. At the beginning of pregnancy, pregnant women need to be managed and closely monitored with an obstetrician-gynecologist and associated specialists if necessary. Additional endocrine therapy, cervical cerclage, tocolysis, antiphospholipid syndrome treatment or amniocentesis, chorionic villus sampling to evaluate genetic abnormalities will be recommended by the obstetrician depending on the underlying cause. core. At the same time, patients need to be consulted and fully examined and tested to detect early signs of thrombosis, signs of pre-eclampsia, intrauterine growth retardation, miscarriage, stillbirth. and signs of drug side effects.
Thành lập phòng khám phụ khoa
Định kỳ kiểm tra sức khỏe sản phụ khoa, giúp mọi người phát hiện bệnh lý sớm

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The world's leading advanced assisted reproductive technology with high efficiency: Using advanced techniques in assisted reproduction helps people with poor sperm quality still be able to have children, reducing the rate of genetic abnormalities In embryos on day 5, immunological evaluation of the uterine lining helps patients with multiple implantation failures have a higher chance of success, accurate embryo genetic screening and diagnosis, and reduce the rate of multiple pregnancies and stop pregnancy. The success rate is from 45%-50%, this rate is equivalent to developed countries such as UK, USA, Australia. 1000 babies were born from IVF at Vinmec. Comprehensive - professional care service: As the leading modern center in Vietnam, applying a treatment process that coordinates comprehensive examination, combining both male and female obstetrics and gynecology to offer the optimal plan for each patient. case. Comprehensive care from infancy to adulthood. Private examination space, customers are consulted and guided specifically and fully by experts. Well-trained and experienced staff: The team of doctors are leading experts in the field of obstetrics and gynecology in the country and internationally, trained at famous fertility centers around the world. world. With a high level of expertise and extensive experience, IVF's staff is capable of synchronously and comprehensively deploying the most advanced assisted reproductive techniques today, helping to realize the dream of becoming a parent. of hundreds of families across Vietnam. System of facilities and modern equipment: Ensure the best embryo culture conditions such as: clean room system level I international standard ISO 14644-1; The culture room is designed with one-way, positive pressure blowing clean air and the culture cabinet system has many separate culture chambers equipped with a time-lapse camera inside the cabinet without disturbing the culture conditions..

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