Although many people experience great joy when they have a positive pregnancy test, it unfortunately lasts only a short time for a large proportion. Each year approximately 20,000 fetuses are lost in Denmark, which corresponds to approximately one in four pregnancies.
If you have three or more miscarriages in a row before week 12 or if you have two or more miscarriages after a normal nuchal fold scan, then you suffer from abortus habitualis or repeated pregnancy loss. A disorder that occurs to approximately 1,200 Danish women each year, and is thus just as widespread as gestational diabetes and pre-eclampsia.
The prognosis for achieving a pregnancy if you have had 3 miscarriages in the past is approximately 50%. A number that increases by approximately 10% for each subsequent loss.
What causes the repeated abortions?
Research from Rigshospitalet from 2017 indicates that approximately half of all pregnancy losses are due to the fetuses having such serious abnormalities or chromosomal defects that they would not be able to survive. In the second half of the pregnancy losses, the explanation must be found with the woman/couple. Previous studies from Rigshospitalet show that the chance that the explanation lies with the woman/couple increases the more pregnancy losses there have been.
The causes, which can be found in the mother/couple, can be chromosomal defects which are inherited. This can be due to lifestyle factors such as overweight/underweight, smoking, alcohol, changes in the uterus, hormonal disorders. And then it also turns out that repeated pregnancy losses have a connection with autoimmune diseases. In other words, diseases where the body's immune system attacks its own cells.
The following can therefore have an influence on repeated abortions:
Malformation of the female uterus
The woman's immune system - it is seen that several women with repeated abortions have special antibodies in their blood
The blood's tendency to dry up - blood-thinning medication can have a positive influence here
What to do?
If, as mentioned, you have had three or more pregnancy losses in a row before week 12 (this includes all pregnancies that have been confirmed. This can be with a positive pregnancy test or a blood test that shows pregnancy, just as it can be with a pregnancy scan) Or two or more losses after normal cervical folding, then you have the diagnosis of repeated pregnancy losses, and you are therefore entitled to a referral for investigation and treatment. However, this requires that you or you contact your doctor in the first instance.
At the doctor
When you go to the doctor, you will typically talk about previous pregnancies. Here it can help to have written down when you were last pregnant, how far along you were when you had an abortion, how long it took to get pregnant and whether you received any kind of treatment to achieve the pregnancy.
The doctor will also ask about the health of the couple or the woman and about any hereditary diseases. If it is a question of repeated abortions, you can be referred for investigation and treatment at a public clinic for repeated abortions/repeated pregnancy loss. There is free choice in relation to where you want treatment, but you must have a referral first. In Denmark, there are the following departments that specialize in repeated pregnancy loss, where you can receive free treatment:
The unit for repeated pregnancy losses - Rigshospitalet - approximately 3 months waiting time https://www.rigshospitalet.dk/afdelinger-og-klinikker/julianemarie/fertilitet/specialfunktioner-i-afdelingen/enheden-for-gentagne-graviditetstab/Sider/default.asp
The unit for repeated pregnancy loss – Hvidovre Hospital – approximately 3 months waiting timehttps://www.hvidovrehospital.dk/afdelinger-og-klinikker/ehenden-for-gentagne-graviditetstab/Sider/default.aspxthe
Region of northern Jutland
Vestdansk Center for Repeated Involuntary Abortions, Aalborg University Hospital - they aim to have a maximum waiting time of one month https://aalborguh.rn.dk/afsnit-og-ambulatorier/gynaekologisk-obstetrisk-afdeling-aalborg/afsnit/gynaekologisk-ambulatorium/om-ambulatoriet/saerlige-funktioner/vestdansk-center-for-gentagne-ufrivillige-aborter
The above are the only specialized departments here in Denmark when it comes to repeated abortions. However, many also get help at public fertility clinics, although there are no special departments for repeated pregnancy losses.
What happens at the hospital?
When the doctor has sent his or her referral to a national unit for repeated abortions, the woman and the man will receive an invitation for a chromosomal analysis (and only the woman if a sperm donor is used). The analysis time on the sample is approximately 8 weeks. In addition, blood tests will also be ordered on the woman. The samples can be taken no earlier than 8 weeks after the last pregnancy loss.
You will be invited to an information meeting at the department, and the woman and any partner will receive a questionnaire. Once these are completed, you will receive an appointment at the specialized department for repeated pregnancy losses.
At the department, you will start with an interview and get answers to the chromosome analysis and blood tests. The woman will have a gynecological examination and ultrasound scan. Here, the doctor will, among other things, investigate whether it may be PCOS; What is PCOS? Symptoms and what you can do if you want to get pregnant – Gravidtid endometriosis What is Endometriosis? Symptoms and what you can do if you want to get – Gravidtid Based on the examination, the chromosome analysis and the blood tests, a treatment plan will be drawn up. When pregnancy occurs, the woman will be closely monitored and possibly receive medical treatment to maintain the fetus.
When the abortions leave deep traces
For many, it can be taboo and difficult to talk about abortions. It may also be difficult to find understanding in the environment if you have an abortion early in the pregnancy.
The research shows that there are significantly more people who are depressed or affected by stress in those affected by repeated pregnancy losses. The difficult feelings are therefore completely normal. Among other things, you can seek fellowship with others in the same situation at the Association for Involuntary Orphans, where there is a network for women who have had repeated pregnancy losses.
Sources: Sundhed.dk, Rigshospitalet, netdoktor.dk, Hvidovre Hospital, Aalborg University Hospital