What is recurrent miscarriage?
Recurrent miscarriage is defined as three successive pregnancies lost after 20 weeks since the last menstruation. The syndrome affects 15% of clinical pregnancy failure and occurs in one in every 300 pregnancies. Pregnancy loss is physically and emotionally demanding for couples.
Antiphospholipid syndrome and its relationship with Recurrent miscarriage.
Antiphospholipid syndrome (APS), is when the immune system abnormally functions to produce antibodies that make blood more with clotting characteristics, this often results in blood clot formation and more severe factors, such as deep vein thrombosis and stroke. APS can also be a risk factor for recurrent miscarriage, as studies have shown that 41% of recurrent miscarriages are caused by preeclampsia or inadequate placental functioning, as well as a correlation with thrombosis such as Deep Vein Thrombosis and stroke.
The importance of the placenta
During pregnancy, the placenta serves as a temporary organ, joining the developing fetus to the mother’s uterus. The placenta delivers oxygen and offers nourishment, removes waste products and carbon dioxide, and supports and shields infants.
Thus, if the placenta is damaged, the blood flow from the mother to the uterus can become inadequate in supply or efficiency, which may result in serious consequences, such as miscarriage or fetal growth restrictions.
How does antiphospholipid syndrome affect the placenta and lead to miscarriage?
Our immune system-produce autoantibodies, known as antiphospholipid antibodies. These autoantibodies attack the trophoblast, which is a type of cell in the placenta, and cause disruption of blood vessel remodelling, which results in decreased blood flow from the mother to the fetus. It can also attack another cell of the placenta, the syncytiotrophoblast, disrupting the barrier between the mother and the fetus, and hindering food and oxygen transmission.
The localization of these autoantibodies was tested with immunohistochemistry, which is a staining technique, in this case, more red means the presence of autoantibodies in the placenta.
A1 is the placenta treated with normal patient serum (without antibodies)
A2 is the placenta treated with patients with APS (autoantibodies present)
From the above image, we can see A2 is redder than A1, indicating there are more autoantibodies present in the patient with APS.
What this means?
It means that the more autoantibodies/redder there is, the more chance a women will experience recurrent miscarriage
Other Risk factors for RM:
- Maternal age
- Poor egg quality
- History of ischemic attack/ thrombosis/ blood clot
- Thyroid problems
- Uterine abnormally shaped
Linking to Chinese acupuncture and medicine
How does traditional Chinese medicine (TCM) link to miscarriages?
In TCM, the major reason for recurrent miscarriage is the spleen and kidney Qi deficiency, and unsurprisingly in most miscarriages, Qi deficiency, or blood deficiency, is known to be the common cause. Dr Virginia Jin comments on most women who experienced episodes of miscarriages, were often mentally stressed, and had difficulties with falling asleep or poor sleeping quality. Additionally, Jin also noticed some women reported abnormality in the uterus structure, as mentioned above in the risk factor section.
Another explanation from the TCM side is that miscarriages are associated with a low temperature of the uterus, thus it is important that a woman who is planning to conceive, she shall avoid cold food and drinks such as ice cream, dessert, cold ice water and alcohol.
5 ways that women planning to conceive should:
- avoid cold drinks and food
- keep body warm (such as hair drying, wearing socks)
- Reduce stress through meditation
- try to improve sleeping quality.
- try acupuncture and Chinese herbal medicine: Herbal enhance and support the Kidney and Spleen organs, by enhancing Qi and nourishing blood. It can also help to deal with sleeping disorders and stress/anxiety.
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