What is recurrent miscarriage & TCM?
Miscarriage is defined as the spontaneous abortion without medical or mechanical means to terminate a pregnancy before the fetus is sufficiently developed to survive. It happens in about 10%–15% of all pregnancies, and it is the most common complication during pregnancy. One can help to reduce miscarriage rate naturally with the use of alternative medicine such as Traditional Chinese Medicine(TCM).
About 5 percent of all couples experience three or more consecutive miscarriages, which is the official definition of recurrent miscarriage. Recurrent pregnancy loss is estimated to happen in 1%–3% of all pregnancies. As a woman ages, risk of miscarriage incrementally increases to a 25% chance in 40–42 years of age and 50% or more in women ages 43–46.
What are the types of miscarriage?
There are 5 different types of miscarriages. They are:
- Threatened miscarriage – normally accompanied with vaginal spotting with or without cervical dilatation and lower abdomen pain. In most cases, the possibility of an intact pregnancy still exists. There is no specific therapy for this form of miscarriage,except for rest or even bed rest if necessary.
- Inevitable miscarriage – occurs when there is a rupture of fetal membranes along with severe vaginal bleeding and cervical, normally indicating fetal loss in most cases.
- Incomplete miscarriage – refers to vaginal bleeding and cervix dilatation, but tissue from the pregnancy still remains in the uterus. It is most common between the eighth and 12th week of pregnancy, but also often occurs only after the 12th week.
- Missed miscarriage – used to describe the presence of a dead fetus and placenta that remained for days or weeks in the uterus without any symptoms.
- Recurrent miscarriage – three or more consecutive miscarriages.
What are the causes of recurrent miscarriage?
No doctor has the ability to predict which pregnancy will miscarry and which one won’t. In order to treat couples more effectively, we look for risk factors to determine who needs additional testing and treatment.
Causes of recurrent miscarriage include(not exhaustive):
- Chromosomal Anomalies – As chromosomes match up with your partner’s, errors may occur and result in miscarriage. The best way to confirm if your pregnancy loss was due to a chromosomal anomaly is to request a karyoptype to check for a balanced translocation.
- Uterine deformities – such as double uterus or a uterus that is divided by a wall (septate uterus)
- Immunological factors – when implantation occurs, the body reacts with both rejection and assistance. The rejection involves primarily natural killer cells while the assistance involves primarily cytokines and growth factors that are produced and secreted by immunocompetitive cells. Implantation can be disturbed by both an excessive rejection or an insufficient presence of cytokines and growth factors, but also by the production of irregular autoantibodies in the context of a false activation of the immune system. (it just means your body is attacking your own cells) Irregular autoantibodies can cause the formation of local blood clots, which ultimately causes the death of the embryo. In terms of therapy, aspirin is usually prescribed.
Two Hormones you need to look out for
By a method I strongly advocate, Basal Body Temperature Charting (BBT charting), we can see if you have a short luteal phase, otherwise known as Luteal Phase Defect(LPD). BBT charting is monitoring your basal temperature everyday and LPD is defined as having a short luteal phase, the second half of your menstrual cycle. This is due to the inability of corpus luteum to produce sufficient progesterone, contributing to early miscarriage. If your progesterone is below 20ng/ml 1 week after ovulation, I recommend that you can see a TCM physician and start taking TCM treatments. TCM treatments are effective in treating LPD.
Women with diabetes and PCOS are more likely to have a miscarriage. This is because insulin plays an important role in establishing the metabolic rate of endometrium, and in doing so, supports implantation. But elevated levels of insulin can interfere with implantation by boosting testosterone. Metformin is usually prescribed to reduce miscarriage rates in women with insulin resistance. Consult a doctor if you are diabetic to see if you need metformin medication.
What should I eat to prevent miscarriage?
1. Omega 3:
This healthy fat can help to improve blood flow to the placenta during implantation and lower the risk of blood clot formation. If you have been following my articles, I have always recommend a plant-based omega 3 supplement because of the mercury content, even in the so-called low-mercury fishes. This is because I prefer my patients to go to the primary source of omega-3, which is algae. You can check it out at amazon here.
With 500mg of omega-3s, Ovega-3 provides the same heart-healthy benefits of traditional omega-3 supplements and oils but without the unpleasant fishy aftertaste and impurities associated with some omega-3 fish oils. The very simple reason being it is plant-based, not fish-based.
3. Avoid excess calories
4. Go organic
How TCM treats miscarriage?
In TCM, miscarriage is defined as “fetal irritability” or “fetal restlessness,” while recurrent miscarriage is called “stirring fetus”. The definition and symptoms of miscarriage in TCM is similar to that of Western Medicine. The presentations of miscarriage are similar, mainly with abdominal pains and vaginal bleeding. But unlike mainstream Western Medicine, TCM has its unique medical theory to comprehend miscarriage.
“Qi” and “Blood” are the two basic elements involved in diagnosing and treating miscarriage. The major causes of threatened miscarriage include
- Kidney Deficiency
- Qi Deficiency
- Blood Deficiency
- Blood Heat
- External Injury
Above are the differential syndromes associated with TCM and each presents with different symptoms. Only a skilled and certified physician can help to diagnose and treat. Self-diagnosis and treatment is strictly prohibited.
Chinese Medicine is also actively used as a treatment for missed, incomplete, and complete miscarriages , which helps to improve the blood circulation so as to stimulate uterine contractions and empty the uterus.
A common concern from my patients is that by preventing miscarriage, they fear intervening with nature and thus increasing the chance of delivering an abnormal baby. This is absolutely NOT TRUE because if your miscarriage is due to a genetic factor, unfortunately the treatments I am going to recommend is not going to prevent miscarriage. However, if the miscarriage is due to other reasons such as hormonal imbalance, blood-clotting problem, then treating this problem not only reduce the risk of miscarriage, it also improves your child’s health.
How safe is the use of TCM herbs during pregnancy?
Since ancient China, pregnant women receive TCM herbal treatments for complaints such as early pregnancy symptoms and backache. As far as we can judge without relevant statistics, there appear to be few problems.
The typical patient in the West, however, will not be prepared to accept even the smallest risk to treat a condition like a cold during pregnancy. Assuming that problems arose after the use of TCM herbs, the TCM physician could very easily be held responsible. In mild illness or when you are unsure, it is therefore better to do without any treatment.
On the other hand, though, if the condition is so critical that the only alternative are biomedical medications that might have incalculable risks for the fetus or if the pregnancy itself is endangered by the illness, for example in threatened miscarriage, then TCM is often the safer method, with fewer side-effects for mother and fetus. It is nevertheless wise to limit both the dosage and the length of usage to what is absolutely necessary.
Unfortunately, there is not enough statistical information and significant data on the safety of TCM herbal treatments. The experience of innumerable generations of physicians certainly counts: many Chinese medicinals and formulas are so well-tested in their application during pregnancy that they can be regarded as safe.
Therefore, for TCM herbs, the situation remains similar to that of the majority of chemical drugs, namely, that neither the safety nor the risk during pregnancy can be definitely ascertained.
TCM has a lost history of treating miscarriage since ancient China. However, one must be careful in choosing a TCM physician as some TCM herbs are PROHIBITED from using during pregnancy. In spite of all these concerns, we should not forget that Chinese medicinal therapy can be extraordinarily effective and have fewer side-effects in threatened miscarriage and many other health problems during pregnancy.
- G. Cunningham, K. L. Leveno, S. L. Bloom, J. C. Hauth, L. C. Gilstrap III, and K. D. Wenstrom, Williams Obstetrics, McGraw-Hill, New York, NY, USA, 22nd edition, 2005.
- J. C. Petrozza, “Early pregnancy loss,” 2009
- Christiansen OB. Nybo Andersen AM. Bosch E, et al. Evidence-based investigations and treatments of recurrent pregnancy loss. Fertil Steril. 2005;83(4):821–839.
- Ryden J, editor; Blumenthal PD, editor. Practical Gynecology: A Guide for the Primary Care Physican.Philadelphia: American College of Physicians; 2002.
- Y. Zan, Jing Xiao Chan Bao, Shanghai Publisher, 1995.