Miscarriage: causes, examination and treatment in Tashkent

Other names: Привычный выкидыш, замершая беременность, привычное невынашивание

Miscarriage is its spontaneous termination before a certain period. One miscarriage happens quite often and in most cases is associated with an accidental chromosomal breakage in the embryo - this is not the woman’s fault and is not an indicator of her health. Recurrent miscarriage and the need for examination are spoken of in case of repeated losses, and there is already a clear algorithm for searching for the causes.

🧾 МКБ-10: N96 🏥 Where it is treated: 3 One miscarriage is often an accidentExamination for repeated lossesThe reason is not always found

👨‍⚕️ Which doctor

Gynecologist, reproductive specialist, geneticist

🔬 Diagnostics

Couple karyotype, APS, hysteroscopy, hormones

💊 Treatment

Depends on the reason

📈 Prognosis

Favorable for most couples

⚠️ At risk

Age, APS, uterine pathology, endocrine diseases

⏱ When to see a doctor

Examination after two losses

🚨 See a doctor urgently

With these signs do not wait for a scheduled appointment — the condition requires emergency care.

Две и более потери беременности
Потеря беременности на позднем сроке
Кровотечение с болью при беременности
Отсутствие сердцебиения плода по данным УЗИ
Тромбозы в анамнезе у женщины или в семье
Мертворождение в анамнезе

What is important to know after the first loss

A single early miscarriage is a common event, and in the vast majority of cases it is caused by a random chromosomal abnormality of the embryo. This is not due to heavy lifting, stress, flying, or the fact that the woman “did something wrong.”

After one loss, the likelihood of a successful next pregnancy remains high, and extensive testing is usually not required. It is indicated for two or more losses, as well as for late loss or in the presence of risk factors.

Separately, it is worth mentioning the feeling of guilt that almost all women experience after a miscarriage. It is natural, but, as a rule, it has no objective grounds. Discussing this with your doctor is just as important as getting tested.

Main reasons

Chromosomal abnormalities of the embryo are the most common cause of early losses; the likelihood increases with a woman's age
Chromosomal rearrangements in one of the parents - detected by karyotyping of the couple
Antiphospholipid syndrome is one of the few causes with proven effective treatment
Pathology of the uterus: septum, synechiae, submucous fibroids, polyps
Chronic endometritis
Endocrine disorders: thyroid disease, decompensated diabetes, progesterone deficiency, PCOS
Isthmic-cervical insufficiency is the cause of losses in the second trimester
Hereditary thrombophilias - the role is discussed, only certain variants are significant
Infections are rarely the cause of recurrent miscarriage
Smoking, alcohol, excess weight and weight deficiency
Woman's age over 35–40 years
In most cases, the cause cannot be determined

Важно понимать про «необъяснимое» невынашивание: даже когда причина не найдена, прогноз у пары остаётся достаточно благоприятным. Отсутствие диагноза — не приговор, а отражение ограниченности методов, и вероятность выносить следующую беременность у таких пар высокая.

Examination for repeated losses

Karyotyping of both partners
Genetic testing of material after pregnancy loss is very informative, if possible
Testing for antiphospholipid syndrome: lupus anticoagulant, anticardiolipin antibodies, antibodies to beta-2-glycoprotein, twice at intervals
TSH and antibodies to thyroid peroxidase
Glucose, glycated hemoglobin
Prolactin
Ultrasound of the pelvic organs
Hysteroscopy or hysterosonography - assessment of the uterine cavity
Pipelle biopsy of the endometrium with testing for chronic endometritis
Ovarian reserve assessment
Spermogram of the partner and assessment of sperm DNA fragmentation
Assessment of body weight, lifestyle, medications taken

Please note what is not on this list: extended panels for thrombophilia, multiple tests for infections, determination of the “compatibility” of HLA partners. These studies are often prescribed, but their evidentiary value in case of miscarriage is low, and they increase the cost and anxiety significantly.

Treatment

Antiphospholipid syndrome - therapy with low doses of aspirin and low molecular weight heparin; one of the most productive situations
Correction of thyroid function
Compensation for diabetes mellitus
Decrease in prolactin levels
Hysteroscopic excision of the uterine septum
Separation of synechiae of the uterine cavity
Removal of submucous fibroids and polyps
Treatment of chronic endometritis with control biopsy
Suture placement on the cervix for isthmic-cervical insufficiency
Progesterone support when indicated
Normalization of body weight, quitting smoking and alcohol
Taking folic acid when planning
IVF with genetic testing of embryos with chromosomal rearrangements in parents
Psychological support and monitoring during the next pregnancy

What to do after a missed miscarriage

Обсудить с врачом способ опорожнения матки: выжидательная тактика, медикаментозный метод или вакуум-аспирация — они предпочтительнее выскабливания
По возможности направить материал на генетическое исследование — результат может объяснить причину и избавить от лишних обследований
Дать организму восстановиться; срок планирования следующей беременности обсудить с врачом
Пройти обследование, если это вторая и последующая потеря
Проверить характер менструаций после вмешательства — их резкое уменьшение может указывать на синехии
Начать приём фолиевой кислоты при планировании
Не отказываться от психологической поддержки — потеря беременности является настоящей утратой

О способе опорожнения матки стоит сказать отдельно: медикаментозный метод и вакуум-аспирация значительно меньше травмируют базальный слой эндометрия, чем классическое выскабливание. Это напрямую снижает риск синехий полости матки и последующих проблем с вынашиванием.

Where to get examined in Tashkent

Gynecological and hormonal examinations, assessment of the uterine cavity by hysteroscopy, endometrial biopsy and laboratory diagnosis of antiphospholipid syndrome are required.

In Tashkent, such an examination is carried out at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic, if necessary, together with a geneticist and a reproductive specialist.

If you are having surgery for a missed miscarriage, talk to your doctor about medication or vacuum aspiration instead of curettage. This decision is made once, but affects future fertility. Clinic contacts are below.

Services and prices for this diagnosis

Based on official price lists of Tashkent clinics. The exact cost is determined after examination.

🔬 Diagnostics

Гистероскопия диагностическая (амбулаторно)from 1 475 000 Пайпель-биопсия эндометрияfrom 525 000

💊 Treatment

ЛДВ при неразвивающейся беременности (амбулаторно)from 2 250 000 ЛДВ при неразвивающейся беременности (анестезия + стационар до 6 ч)from 2 950 000 Гистероскопическое иссечение перегородки матки 1 категории (1 койко-день)from 8 960 000

Frequently asked questions: Miscarriage

After how many losses do you need to be examined?+

Testing is usually recommended after two pregnancy losses. After one early miscarriage, extensive testing is usually not required: the cause is most often a random chromosomal abnormality of the embryo, and the likelihood of a successful subsequent pregnancy remains high.

Am I to blame for the miscarriage?+

Almost never. Normal everyday activities - work, physical activity, flying, stress, lifting bags, sex - do not cause early miscarriage. The vast majority of early losses are associated with random chromosomal abnormalities in the embryo, which cannot be influenced.

What tests are really needed?+

The basis is karyotyping of the couple, examination for antiphospholipid syndrome, assessment of thyroid function, glucose and prolactin levels, as well as examination of the uterine cavity and endometrium. Extended thrombophilia panels, multiple testing for infections, and HLA typing for miscarriage have limited evidentiary value.

What is antiphospholipid syndrome?+

This is an autoimmune condition in which blood clotting increases and the formation of the placenta is disrupted, which leads to pregnancy losses and thrombosis. It is important because it is one of the few causes of miscarriage with proven effective treatment: therapy with aspirin and low molecular weight heparin significantly increases the chances of pregnancy. The diagnosis is made by tests performed twice at intervals.

What to do if the reason is not found?+

This situation occurs quite often and does not mean a lack of hope. Couples with unexplained miscarriage remain highly likely to carry another pregnancy to term. A healthy lifestyle, weight normalization, taking folic acid, monitoring during the next pregnancy and psychological support are recommended.

How soon can you plan your next pregnancy?+

The duration is discussed with the doctor and depends on how the pregnancy was terminated and what kind of intervention was performed. Many couples do not need to wait long if the examination is completed and the condition has recovered. What is more important is not the formal deadline, but the completion of the examination and psychological readiness.

Why is it important how the uterus is emptied?+

Classic curettage injures the basal layer of the endometrium and increases the risk of formation of synechiae of the uterine cavity, which subsequently themselves become the cause of infertility and miscarriage. The drug method and vacuum aspiration are much more gentle, so if possible, they are chosen.

The information on this page is for reference only and does not replace a doctor consultation. Only a qualified specialist can make a diagnosis and prescribe treatment after an in-person examination.

Where it is treated miscarriage в Ташкенте

При повторных потерях беременности обследование должно быть системным, а не набором случайных анализов. В Ташкенте такое обследование, включая гистероскопию и оценку состояния эндометрия, проводят в медицинском центре UROLOGIC COMPLEX и в clinicsе Tashkent Medical Park.