Iatrogenic Causes of Miscarriages

We believe that all doctors want to heal their patients. Still, despite their effort and good intentions, Antai Hospital has seen many cases of recurrent miscarriage misdiagnosis and recurrent miscarriage mistreatment. In medical terms, it is called iatrogenic, meaning “doctor-caused illness” and “medical errors illness.” 

Iatrogenesis recurrent miscarriage occurs because most obstetricians & gynaecologists are not specialized and do not have in-depth knowledge of recurrent miscarriage. The diagnosis is often inappropriate or incomplete. Hence, they are unable to rectify the root causes. With the current advanced diagnostic technologies and treatment methods available, it is no longer necessary for patients to go through multiple miscarriages, wasting their money and time. Timely treatment is critical because women have a ticking biological clock.

Here is the list of iatrogenesis causes that leads to recurrent miscarriage:

Induced Abortion

A patient may have to undergo induced abortion due to medical or personal reasons. Our study revealed that 70 percent of our patients who tested positive for anti-embryonic secondary immune response had gone through induced abortion using abortion pills, vacuum aspiration, or dilation & curettage (D&C). The remaining 30 percent had either experienced prior miscarriage, sex during the menstruation or childbirth. 

Using these “outdated” methods of abortion can lead to recurrent miscarriage, as they are likely to injure the inner uterine lining (endometrium), resulting in the development of anti-embryonic antibodies in the patient’s body. 

The anti-embryonic antibody is an immune response generated naturally by the patient. The anti-embryonic antibodies will identify the embryo as a foreign invader and kill the embryo in subsequent pregnancies.

The correct induced abortion method to prevent future miscarriages is to remove the embryo via hysteroscopy. Hysteroscopy does not cause secondary damage to the uterine lining, and the patient will not develop anti-embryonic antibodies. 

Complicating the first spontaneous miscarriage into recurrent miscarriage

Many doctors do not think it is necessary for the first-time miscarriage patient to visit a miscarriage specialist or do any checks. A miscarriage is pretty common, with 18 to 25 percent of pregnancies ending up in a miscarriage. 

Many women end up suffering from another miscarriage because they did not receive the appropriate diagnosis and treatment for their first miscarriage. This complicates the case as many miscarriage patients have to undergo induced abortions to clear the remaining pregnancy tissues, thus increasing the risk of developing anti-embryonic antibodies. 

Not attempting to save threatened miscarriages

The doctors rationalize that a healthy embryo would survive and advise patients to “let nature take its course”. In many cases, threatened miscarriages are caused by underlying conditions within a woman’s reproductive system. With the advanced medical technologies and techniques we have today, most threatened miscarriages can be saved with timely treatment, no matter how early the pregnancy is. 

Managing threatened miscarriages wrongly 

There are many instances where doctors only prescribe hormonal and vitamin pills to save a threatened miscarriage instead of identifying and treating the root cause. Often, overuse of hormonal pills may lead to other complications, such as the feminization of the male baby or excessive uterine bleeding due to placenta accreta.

In more serious cases of uterine fibroids, the patient will most likely be advised to terminate the pregnancy to remove the fibroids and try for another pregnancy after. If it is a large uterine fibroid, the doctor might recommend removing the fibroid along with the uterus (hysterectomy). Instead of treating a threatened miscarriage, the woman becomes infertile. 

All women should not have any of their reproductive organs removed unless it is cancerous or life-threatening. In Antai Hospital, our standard practice is not removing any reproductive organs unless absolutely necessary. Every organ is crucial for overall health and wellness, especially for women who want to have a baby. 

Incomplete diagnosis

Often, doctors will advise patients that certain diagnostic tests are unnecessary, especially if they have already found one possible reason for the first miscarriage. However, it is common for patients to have a combination of conditions that resulted in the first miscarriage. 

As a result, a recurrent miscarriage will happen because there are still unidentified conditions.

Incomplete treatment

An example would be multiple uterine fibroids. There are instances where a surgeon does not remove all the uterine fibroids, especially the small ones, which are harder to identify. 

Although a small fibroid should not affect your pregnancy, the fibroid can grow in size over time. If a patient decides to have another child a few years later, she might suffer from a miscarriage again because of the enlarged remaining fibroids. 

Misconception regarding embryonic chromosomal abnormalities. 

It is a common misconception amongst patients and doctors that once there is an embryonic demise due to chromosomal abnormalities, then there is no cure because it is a hereditary condition.

As a result, they recommend for patients to have their biological children via surrogacy instead. 

However, embryonic chromosomal abnormalities are the result of internal and external environmental factors, which can be altered to have subsequent successful pregnancies.

Herbal supplements / alternative medication

Many patients take herbal supplements or alternative medications thinking they can help in preventing miscarriages without any scientific evidence. These herbal supplements or alternative medications are not based on any medical diagnosis and not specific to the root cause. Rather, it is more of an experimental treatment. 

Most miscarriage conditions are organic diseases, which will require surgeries that are mostly minimally invasive. 

Most times, herbal supplements or alternative medications cannot treat miscarriage conditions. As a result, patients will delay proper treatment and keep miscarrying while waiting for these herbal supplements or alternative medications to take effect. 

A Note from Antai Hospital

In most cases, couples do not have to suffer from recurrent miscarriages if provided with proper guidance right from the start. All of the points listed above can result in recurrent miscarriages because it delays complete treatment. They will also make your case even more complicated because one condition quickly leads to another if not managed timely. In the worst-case scenario, all these can even lead to infertility.

An experienced and specialized doctor would confirm if there are any reasons for the first miscarriage and advice patients to be on contraceptives until they find the cause. They would advise patients to only get pregnant again after receiving all the necessary treatment. This way, it will save couples from repeated disappointment. 

If your doctor is dismissive of your concerns or does not accede to your requests for certain diagnostic testing, it is a big red flag. 

Antai hospital specializes in the prevention and treatment of recurrent miscarriages. All the medical staff firmly believe that an accurate and comprehensive diagnosis and complete treatment are essential before getting pregnant again. Our doctors’ priority is the needs of a patient, and they will listen to your concerns. 

Additional Information 

In 2016, the British Medical Journal published a study led by Martin Makary, a professor of surgery at the Johns Hopkins University School of Medicine. The study looked at “What were the greatest causes of death in the United States?” 

It was revealed that number one is heart disease, number two is cancer, and number three is iatrogenic illnesses. That works out to be 251,000 people a year die because of medical errors, which is 687 persons a day in the United States alone.

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