Neha had missed her menstrual period and tests showed that she indeed was pregnant! Everybody at home was overjoyed, but the joy was short-lived. She had a bout of bleeding and an urgent USG showed that it was a miscarriage. This was the second time she suffered a miscarriage. Alas, no attempt had been made to find the cause of the first miscarriage, which could have prevented a recurrence the second time!

Cause:

1. Child's causes - Chromosomal and genetic defects, autoantibody.
2. Mother's causes - Uterine tumour, en­dometriosis, inborn defect in structure of uterus, inability of the uterus to carry the preg­nancy, polycystic ovaries, infections, diabe­tes, thyroid disorders, blood group mismatch, medicines taken during pregnancy, addiction to cigarettes and alcohol.
3. Unknown cause.

Investigations:

1. Blood tests for medical disorders, infection and autoantibodies.
2. Hysteroscopy - We can view inside the uterus with endo-camera to find any inborn defect, tumour, polyp etc.
3. USG.

Treatment:

• Treat the medical disorders and infection.
• Hysteroscopy - Inborn defect of uterus, tumour etc. can be removed by endoscopy without any cut on the abdo­men.
• Where the neck of the uterus is loose (cervical incompe­tence) and the uterus is unable to carry the pregnancy, the neck of the uterus is tied with a string - so no operation is required.
  
  

The advances of newer techniques, modern investigations and endoscopy have revolutionised the treatment of the cause of miscarriage. So, it is very important that every miscarriage should be properly investigated and treated to ensure a successful and safe delivery the next time. About Neha, you shall be happy to know, that after thor­ough investigations, the cause was found and rectified. She delivered a healthy baby within an year.