Recurrent miscarriage is the spontaneous loss of three or more consecutive pregnancies in the first trimester. It affects 1-2% of women, half of whom have no identifiable cause. The causes of recurrent pregnancy loss (RPL) are classified as genetic, anatomic, endocrinological, immunological, microbiological and environmental. Anatomic abnormalities account for 10% to 15% of cases of RPL and are generally thought to cause miscarriage by interrupting the vasculature of the endometrium. There is an association between RPL and heritable thrombophilias which is a condition where the blood has an increased tendency to form clots. Blood clot impairing placental development and function could lead to miscarriage. Imbalanced hormones such as abnormal LH surge, low progesterone and high androgen result in premature egg aging and impaired endometrial development.
Uterine blood flow changes can be seen in the uterus and ovaries during the menstrual cycle and uterine blood flow affects uterine receptivity and an important factor in achieving a normal pregnancy. Differences in uterine blood flow impedance between fertile and infertile women and reduced uterine blood flow may be one cause of unexplained infertility. Recent research also has suggested that impaired uterine blood flow is associated with recurrent pregnancy loss. In women with recurrent miscarriage their blood flow resistance in uterine artery was elevated which means the blood flow was reduced. As we can see that reduced blood circulation in endometrium and placenta is the reason for many miscarriages.
The treatments for recurrent miscarriage are limited. There is a systematic review that evaluated the effectiveness of current treatment methods. Their finding is as follows:
Bed rest: they found no systematic reviews or control trials to show the effectiveness of bed rest in women with recurrent miscarriage.
Early scanning in subsequent pregnancies: There were no systematic review and control trials for this method. Early scanning might reduce anxiety of women with recurrent miscarriage which may be beneficial.
Human chorionic gonadotrophin (HCG) treatment: There were four control trials showing that HCG reduced the miscarriage rate though the standard of the trials were not high.
Progesterone treatment: One systematic review showed that progesterone reduced miscarriage rate.
Intravenous immunoglobulin treatment, trophoblastic membrane infusion, paternal white cell immunisation: There were high standard control trials showing that these treatments did not increase live birth rate in women with recurrent miscarriage.
Lifestyle adaptation (stop smoking, reduce alcohol consumption, Loss weight): There was no systematic review or control trial to show the effectiveness of this methods on recurrent miscarriage.
Low dose aspirin, oestrogen, corticosterioids, vitamin supplementation: There was no systematic review or control trial showing effectiveness of these treatments in women with recurrent miscarriage.
Acupuncture was applied to treat miscarriage in China. There was a case report by Zhang in Tianjin gynecology hospital showing effectiveness of acupuncture in women with recurrent miscarriage. This report is involved 558 cases with recurrent miscarriage. 86.6-93% cases were successful.
In early pregnancy your body starts to change because of the hormonal changes in the body. For example, the uterine and vaginal lining becomes ticker and breast becomes tender. When miscarriage occurred, your body has to go back to normal from the pregnancy loss, physically and emotionally.
Acupuncture can help you recover from miscarriage and get your body ready for next pregnancy. Acupuncture stimulates nerve endings to helps hormone balance; improves ovarian and uterine blood flow; reduces inflammation and reduces stress. All of these could help prevent miscarriage from happening again and have a successful pregnancy.
Duckitt K and Qureshi A Clin Evid (Online) 2008 pii:1409
Alexandros Sotiriadis BMJ 2004 http://www.bmj.com/content/329/7458/152