Seeking medical advice after a miscarriage can help you to understand what happened and what it means for any future pregnancies. Although the miscarriage advice you get from your doctor will mainly be medical, the support we provide can also help you through this experience.
We understand that the loss of a pregnancy is a difficult time in the life of a couple. Most early miscarriages are sporadic with no easily identified medical cause. Sporadic miscarriages are commonly followed by a healthy pregnancy and delivery. The consecutive unexplained loss of three miscarriages usually requires further investigation for what is defined as recurrent miscarriage.
Although it can be impossible to identify a specific cause after a miscarriage, there are tests that can sometimes help to understand what happened. The results will help your doctor to provide personalised miscarriage advice, including advice for any future pregnancies.
Detailed blood investigations are advised, these will cover the diagnosis or assessment of possible coagulative disorders such as thrombophilias . If there is a high suspicion of genetic causes, a genetic screen can be performed for both partners. Other blood tests will be performed to assess for a range of medical conditions such as Thyroid dysfunction or dysfunction of the pituitary gland (e.g. prolactinoma)
Radiology investigations such as pelvic ultrasound scans or MRI will be used to assess for any uterine anomalies. A hysteroscopy is advisable if there is a high suspicion of uterine pathology.
With late or second trimester miscarriages, we will also assess for cervical incompetence . This defect in the functioning in the cervix may follow a past surgery to the cervix (such as a LLETZ procedure for irregular cervical cells) or may be due to a medical tissue disorder such as systemic lupus erythematosis (SLE). Depending on your previous obstetric history, we will assess the cervical length prior to and during your next pregnancy. If appropriate, a detailed discussion exploring the benefits and risks of insertion of a cervical stitch or suture will be discussed with you in clinic.
Genetic and histology analysis of recurrent miscarriage will be offered to help in the management of your case and plan for future pregnancies. This is optional and will be discussed in detail with you at your clinic visit. Depending on the identification of the causes for the miscarriage, treatments such as aspirin or in some cases low molecular weight heparin (Clexane) might be advised to maximise the chances of future pregnancies.
Having tests after a miscarriage help you to understand what has happened, while the support provided at the clinic can help you to address the emotional impact of miscarriage. Seeking miscarriage advice from your doctor can help you to address the concerns you might have about your health and the decision to try to conceive again. You will have a chance to ask questions and talk through the results.
Just having someone to talk to after a miscarriage can make a big difference. Please consult or take advice from Mr Colin Davis on miscarriage at his private clinic in London.