Preventing Miscarriage: The Good News (revised Edition)

Preventing Miscarriage, The Good News Preventing Miscarriage • the good news• 1 JONATHAN SCHER, M.D., and CAROL DIX Preventing Miscarriage, The Good News Preventing Miscarriage, The Good News This book is dedicated to all my patients who had the courage not to take NO for an answer and who never gave up hope in their quest to have children. Preventing Miscarriage, The Good News Preventing Miscarriage, The Good News CONTENTS 1 List of Illustrations Acknowledgments Introduction Part 1: Miscarriage and You 1 “You Don’t Ever Forget a Miscarriage” 2 When the Bleeding and Cramping Spell Trouble Part 2: Why Did It Happen?  What Tests and Treatments Are Available? 3 4 5 6 What Are the Genetic Causes of a Miscarriage? What Are the Anatomical Causes of a Miscarriage? What Are the Hormonal Causes of a Miscarriage? Can Ordinary Infections or a Virus Cause  a Miscarriage? 7 Diseases and Disorders in the Mother or the Father Preventing Miscarriage, The Good News v vi ix 1 3 30 77 79 92 117 155 166 Preventing Miscarriage, The Good News iv / Contents 8 Immunological Causes of Miscarriages: Is There a Mismatch Between You, Your Partner, and the Baby? 9 Environmental Factors and Their Effect  on Miscarriage Part 3: Are You Ready to Try Again? 10 Why Healthy Grieving Is So Important 11 What Should You Expect During Your Next Pregnancy? Resources Index 176 199 221 223 247 265 271 About the Author Praise Credits Cover Copyright About the Publisher Preventing Miscarriage, The Good News Preventing Miscarriage, The Good News LI ST O F I L LUST R AT I O N S 1 Figure Figure Figure Figure 1 Ultrasound photograph of a missed abortion 2 Ultrasound showing a blighted ovum 3 Fetal movement chart 4 Chromosome content of human cell,  from amniocentesis Figure 5 Uterine abnormalities Figure 6 Placement of the cervical stitch Figure 7 Normal anatomy of the vulva Figure 8 Relationship of internal genital organs Figure 9 Hormonal control of ovarian and endometrial lining of the uterus Figure 10 Stages of development of a human baby Figure 11 Immune response and the embryo Preventing Miscarriage, The Good News 50 52 72 83 93 110 134 136 139 148 181 Preventing Miscarriage, The Good News A C K N OW L E D G M E N T S 1 I would like to thank my colleagues of the American Society of Reproductive Immunology who by doing their research are expanding our knowledge of the miracle of pregnancy and thereby helping women have children when they might not have done. Thank you too to my many esteemed colleagues who have referred patients to me and whose enthusiasm has been so valuable to me in this emerging field. I would like to thank organizations such as the American Fertility Society and Resolve who give support to patients who repeatedly lose their pregnancies through an emotionally devastating experience. I would also like to thank Carmen Dabao, my professional assistant and right hand for believing in what I do and helping in the care of my patients. Thanks to the rest of my office te