Repeated miscarriages overthrow every woman in a mental state of emergency of sadness and helplessness. Emotional support is important now, as the search for medical causes. One reason multiple abortions may be an undetected blood clotting disorder (thrombophilia).

Bleeding disorder: cause of miscarriage

Ultrasound for pregnant women

Photo: © Panther Media / Alexander Raths

For each expectant mother, it is the biggest nightmare, the unborn child whose heart was even has seen beating to lose. About 10 to 15 percent of all recognized pregnancies end in miscarriage, the risk of this is in the first twelve weeks at the most. About 80 percent of all abortions are taking place at this early stage. Approximately 2 to 5 percent of all pregnant women, it is especially hard: you have to experience this nightmare two or more times in a row. Doctors refer to this case of so-called habitual miscarriages (recurrent miscarriages). The reasons are not always easy to find because symptoms bleeding disorder are not clearly visible. Nearly half of all miscarriages, doctors can even assign no reason. In the cases where the relevant factors are found, the causes are many. If a woman has two or more consecutive miscarriages, a possible cause may be an unrecognized bleeding disorder. Due to the increase in volume and hormonal changes, the blood of each pregnant woman tends to clot faster than normal. There is also a clotting disorder, which is a tendency to thrombosis, suspected small micro thrombosis in the blood vessels of the placenta. So the embryo can not settle just right or are not properly taken care of and there is a miscarriage itself.

Not every bleeding disorder leads to miscarriage

However, do not suffer any woman who has a blood disorder that inevitably miscarriages. Only the reverse is very noticeable by clinical experience: "Around 20 to 25 percent of women with two or more miscarriages have abnormalities in the blood clotting. This one tries to treat - whether as part of a spontaneous pregnancy or in vitro fertilization, "the Hamburg professor explains Dr. Frank Nawroth, specialist in gynecology and obstetrics and gynecological endocrinology and reproductive medicine. 

What types of thrombophilia are there?

Thrombophilia is the umbrella term for various bleeding disorders, all of which lead to an increased risk of thrombosis. The coagulation disorders consist of either from birth or acquired later in life. You can stay or completely without clinical effects trigger symptomatic thrombosis. The following coagulation disorders are associated, according to clinical studies, especially with recurrent miscarriages:

Bleeding disorder factor of 5

The most common hereditary risk factor for thrombosis is the so-called Factor V Leiden (APC resistance). In about 5 percent of the European population, this type of thrombophilia occurs, the cause is a gene defect. A pregnant woman with a Factor V Leiden has, according to clinical studies, a 28 percent higher risk of thrombosis than mothers without a clotting disorder factor. 5

Antiphospholipid syndrome (APS)

Studies show that up to 5 percent of the population APS antibodies acquired inhibitors of clotting, in the blood. This does not affect forcibly and can remain completely without symptoms. However, pregnancy complications such as repeated miscarriages occur in patients with APS disproportionately on.

Protein C and protein S deficiency

Women, who lack the so-called protein C or protein S (or both at the same time), have during pregnancy, a 10 to 19 percent greater risk of thrombosis.

Antithrombin deficiency

In an antithrombin deficiency, the risk of thrombosis, and thus the risk of complications in pregnancy up to 44 percent. Fortunately, this kind rarely comes before the thrombophilia.

Some women also suffer from several types of bleeding disorder as causes of complications. Here, the more thrombophilia factors a woman carries within itself, the greater the probability that it comes in a pregnancy complications such as miscarriage.

Clotting disorder thrombophilia: diagnosis and treatment

"Surely it makes no sense to any woman who wants to get pregnant to test just once on thrombophilia"Warns Professor Dr. Nawroth. It would only make unnecessary the horses shy, since it is known that undiagnosed bleeding disorders sometimes have no effect. In one patient, a clotting disorder is present, but there was never any symptoms. Another has suffered with exactly the same diagnostics if 20 years their first thrombosis. "In the past we have performed a test for thrombophilia only from the third miscarriage in a row. Today we examined after the second abortion, because it has been found that it is medically already makes sense from that point", The expert in coagulation disorders and infertility explained. The same is true for patients who are artificially inseminated. "It has been found that the collective of women who have suffered multiple miscarriages, the collective of women who did not become pregnant after repeated IVF, is very similar"Says Nawroth.

Simple blood test gives information

A simple but specific blood test finally brings information on whether the patient suffers from a clotting disorder. Meanwhile, you can even make a self-gene test from home, this one chicken (personal genomics services). A few days later you get the result then sent by mail. Whether this is a good idea, however, remains questionable. For one advice and support from a specialist just in a subsequent treatment is urgently needed. Secondly, you would have to also pay the test in self-order itself. However Tells the doctor after a second miscarriage, a blood test that health insurance companies cover the costs.

Heparin Study: No positive effects for pregnant women

If the result of the test at the end, that thrombophilia is, the doctor will discuss with the affected woman which treatment is now sensible and will propose under certain circumstances, an appropriate form of fertility treatment. For a long time held many specialists in affected women, treatment with the anti-thrombosis drug heparin for the best choice - and do so even today. But the call of heparin therapy to be the easiest way to self-medication by injection not only easy home feasible, but also counteract the known blood clotting disorders, falter: After a recently published study ("Ethig II trial") Of Geburtsmediziniern from Germany and Austria, where from 2006 to 2013 a total of 449 pregnant women were involved, increased heparin neither the number of ongoing pregnancies still live births in women with recurrent miscarriages. "We can no longer assume a positive influence of the drug", Summarizes Professor Ekkehard Schleußner, Managing Director of the Department of Obstetrics and Gynecology at the University Hospital Jena and medical Leitter the study, the results. In the study, doctors treated women with recurrent miscarriages, which, however, did not suffer a risk of thrombosis. In their case, no advantage could be proven through the use of anti-clotting drug. Therefore Schleußner also stressed: "It is not recommended to treat pregnant women with no risk of thrombosis with heparin."