A Word with the DOCTOR
by Dr John Winsor
The Sunday Times of Malta


DEALING with repeated miscarriages is one of the many distressing situations that a doctor has to deal with in his professional life.

A miscarriage can be triggered by a whole host of factors. The most common ones are anatomical and genetic abnormalities but there are others.

For example, smoking increases the risk and diseases are also associated with miscarriages. These include thyroid trouble, diabetes and a wide range of infections, from German measles (rubella), mumps, influenza, listeriosis and toxoplasmosis to herpes and malaria.

Factors in repeated miscarriages are more likely to be hormonal imbalance or an abnormality of the womb. The uterus may have two horns instead of one cavity and there is less room for baby to grow.

Previous womb infections or PID - pelvic inflammatory disease, where the genital organs are damaged and scarred, can also be a cause.

Babies in the wrong place - in the confined space of a Fallopian tube, which normally conducts the egg from the ovary to the uterus - miscarry around six to ten weeks. This is an ectopic pregnancy. One in 140 pregnancies are ectopic and are more common in women over the age of 30.

But there are also many myths about recurrent miscarriages. One is that a backwards-pointing womb, or retroverted uterus, causes abortions. It definitely doesn't. Sexual intercourse doesn't either, nor an examination by your doctor.

Miscarriages are traumatic events and in cases of recurrent miscarriages, I suggest a low-key approach. Don't tell anyone but your doctor at first. Let your partner into the secret later at an opportune moment and rest as much as possible.

Get a scan after six weeks as this will show if baby is developing and in the right place. Your doctor can arrange this.

When you've got to the magic 12 weeks or later, when miscarriages are less likely to happen, then you can let everyone in on your happy news.