Repeated Abortions (Bad Obstetric History – BOH)

What Is Repeated Abortions (BOH)?

BOH refers to a history of two or more pregnancy losses, whether they occur early in the first trimester, late in pregnancy, or result in stillbirth. These losses can happen consecutively or at different stages of a woman’s reproductive life.

Is It Common?

It’s estimated that about 1% to 2% of women experience recurrent pregnancy loss. While this might feel isolating, knowing you’re not alone is important. BOH is a medical condition that doctors can often help diagnose and treat with personalized care.

Causes of Repeated Abortions

Understanding the reasons behind recurrent pregnancy loss can help determine the best approach for treatment. Causes of BOH can vary from genetic factors to lifestyle or medical conditions.

1. Genetic or Chromosomal Issues

• Around 50-60% of early pregnancy losses are linked to chromosomal abnormalities.
• An imbalance in the baby’s genetic makeup can prevent proper development.

2. Hormonal Problems

• Hormonal imbalances, such as low progesterone levels (a hormone that helps sustain pregnancy), can lead to miscarriages.
• Women with thyroid disorders or polycystic ovarian syndrome (PCOS) may also face higher risks.

3. Uterine Abnormalities

• Structural issues in the uterus, like a septum (wall dividing the uterus) or fibroids, can interfere with implantation or growth of the fetus.
• Scarring from previous surgeries or infections may also impact the uterus.

4. Autoimmune Disorders

• Conditions like antiphospholipid syndrome (APS) cause the immune system to mistakenly attack normal body tissues, leading to pregnancy complications.

5. Blood Clotting Disorders

• Clotting issues, like thrombophilia, can restrict blood flow to the placenta, causing pregnancy loss.

6. Infection

• Certain infections like rubella, toxoplasmosis, or untreated sexually transmitted infections (STIs) can increase miscarriage risks.

7. Lifestyle Factors

• Smoking, alcohol use, drug abuse, or a lack of proper nutrition may contribute to pregnancy loss.

8. Unknown Causes

• Despite modern testing and technology, around half of BOH cases remain unexplained.

Symptoms and Diagnosis

How Do You Know It’s BOH?

The primary symptom of BOH is experiencing multiple consecutive pregnancy losses. Depending on your specific condition, other symptoms may include hormonal irregularities (e.g., irregular periods) or abdominal pain during pregnancy.

Diagnostic Tools

Accurate diagnosis is vital for your treatment plan. Doctors may use several tests, such as:

1. Blood Tests
• These check for hormone levels, autoimmune conditions, or clotting disorders.
2. Imaging Tests
• Ultrasounds or hysteroscopy (a procedure to examine the uterus) help identify structural problems.
3. Genetic Testing
• Both parents may undergo testing to uncover chromosomal abnormalities.
4. Testing for Infection
• Screening for infections that can lead to repeated pregnancy loss.

Treatment and Management Options

Good news—most cases of BOH can be treated or managed effectively, allowing many women to achieve successful pregnancies. Treatments depend on the underlying cause.

1. Medication Therapy

• Hormonal Supplements: Progesterone supplementation may help sustain pregnancy.
• Blood Thinners: Medications like aspirin or heparin are used for clotting disorders to improve blood flow to the fetus.
• Antibiotics: If infections are found, treatment with antibiotics is initiated.

2. Surgery

• Structural issues like uterine septums or fibroids can be corrected through minimally invasive procedures like hysteroscopy.

3. Genetic Counseling

• If genetic issues are found, genetic counseling helps couples understand the risks and consider options like IVF with preimplantation genetic testing.

4. Lifestyle Modifications

• Quitting smoking, reducing alcohol intake, maintaining a healthy weight, and managing stress all play a major role in improving pregnancy outcomes.

5. Fertility Treatments

• Assisted reproductive technologies, like IVF (in vitro fertilization), may be recommended for certain cases.

Potential Complications

If BOH is not diagnosed or managed effectively, it may lead to challenges such as:

1. Physical Impact on the Mother
• Recurrent miscarriages can cause anemia, uterine scarring, or complications in future pregnancies.
2. Psychological Stress
• Women with BOH often experience grief, anxiety, and depression, reinforcing the importance of emotional support and mental health care.
3. Delayed Pregnancy Outcomes
• Repeated pregnancy losses may delay successful pregnancy without proper care and assistance.

Precautions to Take

While not all factors leading to BOH are preventable, certain steps can reduce risks and promote a healthy pregnancy.

1. Plan Prenatal Visits Early
• Begin prenatal check-ups as soon as you conceive to monitor the baby and manage risks.
2. Follow a Nutritious Diet
• Focus on foods rich in vitamins, folic acid, and iron to promote fetal development.
3. Take Prescribed Supplements
• Don’t skip any supplements, like prenatal vitamins or progesterone, if recommended by your doctor.
4. Avoid Harmful Habits
• Stay away from smoking, alcohol, and recreational drugs during pregnancy and pre-conception planning.
5. Stress Management
• Managing stress through yoga, meditation, or therapy can have a positive impact on your pregnancy health.

Lifestyle and Support Recommendations

Coping with recurrent pregnancy loss can feel lonely, but there are ways to regain hope and confidence.

Focus on Self-Care

• Get plenty of sleep and engage in light, regular exercise with your doctor’s approval.
• Lean on your support system of family and friends to share this emotional burden.

Seek Professional Counseling

• After repeated losses, counseling or joining a support group can help you process emotions of grief.

Trust Your Medical Team

• Establish a trusting relationship with your healthcare provider. They’re here to guide and support you through each step.

Frequently Asked Questions (FAQs)

At Mamata Fertility Hospital, we know how challenging it can be to face repeated abortions. Our team of specialists is here to provide compassionate, personalized care to help you achieve your dream of a successful pregnancy. Book a consultation today—together, we’ll write the next hopeful chapter of your story.

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