Habitual Abortion

The term abortion refers to the expulsion of the fetus from the uterus before the complete formation of the placenta. It is also commonly known as miscarriage. This may occur any time before 28 weeks of gestation but is most common during the first 12 weeks of pregnancy. Once in five to ten pregnancies terminates in this way.

When miscarriage occurs repeatedly at a certain period of pregnancy, it is termed " habitual abortion ". It is one of the most perplexing problems of gynecology and a major cause of maternal mortality. A woman who has suffered two or more terminations of this sort consecutively is said to be a case of habitual abortion.

Symptoms

Pains of the same character as labor pains and bleedings are the two main symptoms of possible abortion. Bleeding may lead to the detachment of the ovum from the uterus. It now acts as a foreign body in the uterus which stimulates uterine contraction. This generates a lot of pain and the fetus is thrown out of the body. In later weeks when the fetus is well developed, if it dies in the uterus, it leads to maceration of the body. The abdomen is filled with blood and the skin co lour appears red. Sometime after a few more days, the fetus gets dehydrated and the fluid surrounding the fetus gets dried away.

Causes

One of the most important cause of habitual abortion is a congenital malformation of the uterus. A hysterogram, before the woman becomes pregnant, will be useful in detecting any abnormality, so that she is made aware of her case. Deficient functioning of the thyroid is another important cause of habitual abortion.

Most cases of habitual abortion, however, result from an inadequate secretion of the female hormone progesterone. This hormone is responsible for the development of the placenta. In the early stage of pregnancy, the gonadotrophin secreted by the cytotrophoblast of the chorion, one of the foetal membranes, stimulates the corpus lotemum to produce more oestrogen and progesterone, both essential female hormones. At a later stage, by about the 12th week of pregnancy, the placenta takes over the production and secretion of the hormones. Any deficiency of these hormones at this stage is detrimental to the growth of the fetus. It is, therefore, during this critical period,when habitual abortion mostly occurs. Lack of progesterone is especially instrumental in expelling the fertilized ovum and it results in an abortion.

Another important cause of habitual abortion may be chronic constipation which leads to putrefaction of morbid matter and wastes in the large intestines. This in turn causes auto-intoxication and inflammation of the reproductive organs, which can lead to a miscarriage. Abortion may result from the excessive use of certain drugs. Drugs enter the fetus through the placenta. They may act quite differently on the fetus from the mother. Drugs which have adverse effects on the fetus are called " tera-togenestic drugs " and may include painkillers, antibiotics, tranquillizers and hormones. A high dosage of such drugs may produce contraction in the uterus and induce abortion.