Tuesday, October 02, 2007

Different conditions may cause a miscarriage

Q: I recently had a miscarriage at 9 weeks, and would like to know how long to wait before trying to get pregnant again. What causes a miscarriage to happen? Is there any way I can prevent it from happening again?

Answer: When a miscarriage happens, we are forced to bear witness to the complexity of human life and the mystery of creation. Miscarriage is often kept private, despite its rather frequent occurrence (15-25 percent of all pregnancies). Most miscarriages happen during the 13 weeks of the first trimester, but they can occur up to the 20th week of gestation.

Trying to explain the loss may be a simple matter of the mother’s age: Over the age of 35, the risk of chromosomal defects that are incompatible with life increases. For example, the risk of any chromosomal defect occurring at age 26 is estimated at 1/476. The risk of any chromosomal defect occurring at age 40 is 1/66. About 7 percent of all miscarriages or stillborn deaths are due to a chromosomal abnormality.

The mother may have a disease or infection that’s contributing to an unfavorable environment for a developing baby to grow and develop. Examples include severe kidney disease; uncontrolled diabetes; an underactive thyroid; auto-immune disorders like rheumatoid arthritis or lupus; or a uterine infection from a sexually-transmitted disease like chlamydia, gonorrhea or herpes simplex virus.

There’s also a disorder known as “anti-phospholipid antibody syndrome” in which the mother is at increased risk of blood clots -- especially affecting the blood vessels of the placenta -- that can be a cause of miscarriages. There are also anatomical factors like an abnormally shaped uterus or a short and weak cervix that increase the risk of miscarriage.

Exercise during pregnancy, sexual intercourse during pregnancy, colds, and working during pregnancy are not generally considered harmful to a developing baby.

If your pregnancy was longer than 6 weeks, there are developmental hormones, such as progesterone, that need to return to pre-pregnant levels. I’d therefore recommend a resting period of at least 60-90 days. The emotional healing time, however, may take longer than that.

Dr. Mitchell Hecht is a physician specializing in internal medicine. Send questions to him at: “Ask Dr. H,” P.O. Box 767787, Atlanta, GA 30076. Due to the large volume of mail received, personal replies are not possible. Anonymous, New York, N.Y. P.A., Huntsville, Ala.


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