Jess Owen 30th October 2018
About one in four women will have a miscarriage in their lifetime, with three in every four miscarriages happening in the first 12 weeks of pregnancy.
A miscarriage is when a woman loses a baby within the first 23 weeks of pregnancy. There are lots of reasons why someone might miscarry, and those who have a miscarriage often never find out why it happened, as the NHS only investigates after three miscarriages.
The most common reason for losing a baby is thought to be a chromosome abnormality. Everyone is made up of DNA and, except for identical twins, each person’s DNA is unique to them. In every DNA molecule is a nucleus, which contains chromosomes. Human body cells contain 23 pairs of chromosomes, and these control gender, hair colour, eye colour and so on. When a baby has too few or too many chromosomes when it is developing, this can cause a miscarriage.
If a miscarriage occurs between the 14th and 26th week of pregnancy, this is often because the mother has an underlying health issue.
Up until now, it was thought that the majority of miscarriages can’t be prevented — however, research conducted by a team of scientists at the University of Leeds have been looking at how MRI scans could be used to understand why some women miscarry or go into early labour.
MRI, which stands for magnetic resonance imaging, is a type of scan that uses strong magnetic fields and radio waves to produce detailed images of the inside of the body. If you have ever watched Holby City or any other medical television programme, then you will have seen patients being slid into a large round and hollow machine ready for an MRI scan.
Women who were having a hysterectomy allowed us to use their organs to study
The team at Leeds have created 3D images of the cervix, the organ below the womb, using these MRI techniques — unbelievably, this is the first time such high-resolution imaging has been used to understand the structure of this organ.
“This research has helped our fundamental understanding of the structural complexity of the cervix,” says Nigel Simpson, associate professor in obstetrics and gynaecology at the university.
“Women who were having a hysterectomy (an operation to remove the womb) allowed us to use their organs to study, as it would not be possible to use such strong techniques at this stage on organs still intact.”
Around a quarter of miscarriages during the fourth to sixth month of pregnancy occur because of weaknesses in the cervix, which essentially holds the foetus in place and stops it entering the birth canal. Therefore, understanding why this happens may help to prevent such losses.
Women who are at risk of miscarriage can have a small stitch inserted around the cervix, known as a cerclage, to provide extra support. However, predicting which women need this surgery is difficult.
The scientists at Leeds hope that by developing a detailed understanding of the cervix, they can develop ways of identifying potential problems within a woman’s body before they become pregnant, and consequently provide them with the necessary treatment.
For most women, a miscarriage is a one-off event, and many go on to have successful pregnancies and healthy children. However, a small minority of women suffer multiple miscarriages, which can be devastating.
Currently, most of the advice about avoiding miscarriage is focused on a woman’s lifestyle. Women are warned to stop drinking alcohol, quit smoking and don’t take drugs, in addition to maintaining a healthy weight and having a balanced and healthy diet during pregnancy.
The thought that a simple check could prevent it happening to other people is really good news
Some women believe being able to check for these issues could have prevented multiple miscarriages.
“I suppose having had so many miscarriages, I would have definitely accepted a scan had it been available, but perhaps not if I hadn’t had so many losses,” one woman, who had four miscarriages, says.
A woman who had eight miscarriages in her early 20s says: “I think I would have had the scan if it had been available but honestly don’t know if it would have helped.”
However, other women say it’s unlikely they’d have had a test up front, which means they would not know about a problem with their cervix before they got pregnant. A woman who miscarried twice says: “The first time, I wasn’t aiming to get pregnant, so there’s no way I would have even considered being checked for cervical problems. The second time, I’d had two healthy children by then, so I considered the first one a ‘one-off’ and, again, wouldn’t have been checked.
“But, it sounds like a positive thing, even if it’s only effective for a small number of people. I was devastated both times it happened to me and the thought that a simple check could prevent it happening to other people is really good news.”
Jess Owen 30th October 2018