For a woman who longs for a baby, miscarriage brings heartbreak—and the experience is even more devastating when it happens repeatedly. Unfortunately, that is all too common, with an estimated one in 100 women suffering from recurrent miscarriage, meaning three or more consecutive pregnancy losses prior to 24 weeks’ gestation. About half of such cases have no known cause. But now there’s new hope, thanks to a recent study linking a specific uterine problem to recurrent miscarriage…and identifying a solution that may help many women give birth to healthy babies at last.
The study looked specifically at uterine fibroids, benign tumors composed of muscular and connective tissue that grow on the inner or outer walls of the uterus. Though fibroids cause intense pelvic pain and prolonged menstrual periods in some women, in other cases they cause no obvious symptoms—so a woman may not even be aware that she has fibroids. It is well-known that the growths can interfere with a woman’s ability to become pregnant, but this study is the first to look at the prevalence of different types of fibroids and their impact on recurrent miscarriage.
Researchers analyzed data on patients who had been referred to a recurrent miscarriage clinic, including 79 women who had uterine fibroids. Most of these growths were types that do not distort the uterine cavity and thus are not typically treated with surgery. However, 25 patients had a type called a submucosal fibroid that forms in the muscle beneath the uterine lining and grows into the middle of the womb, distorting the uterine cavity. All 25 underwent myomectomy, a minimally invasive surgery to remove their submucosal fibroids.
Findings: Prior to their surgery, the submucosal fibroid patients as a group miscarried more than three-quarters of their pregnancies and had a live birth-rate of just 23%. Often their miscarriages occurred during the second trimester, between 13 and 24 weeks’ gestation—which can be even more difficult physically and emotionally than an early miscarriage. However, in their first pregnancies after surgery, none of these women suffered a second-semester miscarriage (though some did have early miscarriages)…and their live-birth rate more than doubled, rising to 52%.
Takeaway message: Researchers advised that women with a history of second-trimester miscarriage and/or recurrent miscarriage get screened for submucosal fibroids (which can be diagnosed with ultrasound) and be offered myomectomy if the growths are found. Women whose fibroids do not distort the uterine cavity, however, often can successfully give birth without surgical intervention.