Up to 20 per cent of pregnancies end in miscarriages

As many as 20 out of 100 pregnancies end prematurely because of chromosomal abnormalities in the foetus while introduction of laparoscopic surgery to end ectopic pregnancy marks a major leap ahead from the extended recovery period required after common surgery. Experts addressing the “Signs, Symptoms and Care,” a public health awareness programme at Aga Khan University (AKU), discussed the issues surrounding early loss of pregnancy and shed light on the recent advancements in the field of obstetrics.

“Miscarriage is pregnancy loss prior to 24 weeks gestation. It occurs in 10 to 20 per cent of all pregnancies and may be associated with significant psychological sequel,” said Dr Rozina Sikandar, Assistant Professor, Consultant Obstetrician and Gynaecologist, Aga Khan University Hospital (AKUH), Karachi in her presentation on ‘Early Pregnancy Loss and Recurrent Miscarriage.'

Foetal chromosomal abnormality (error in development of baby in utero) is the most common cause of early miscarriage, i.e. pregnancy loss before 12 weeks, which accounts for majority of cases, while late pregnancy loss (between 12-24 weeks) occurs less frequently and constitutes less than three per cent of all pregnancy outcomes.

All couples with a history of recurrent miscarriage should be evaluated for a possible cause, although a significant proportion of cases remain unexplained, despite detailed investigation. While this is a frustrating situation for the patient and the doctor, it is reassuring that the prognosis in these women for a successful future pregnancy with supportive care is 65-75 per cent.

Dr Nadeem Faiyaz Zuberi, Assistant Professor and Consultant Obstetrician and Gynaecologist, AKUH, discussed ‘Ectopic Pregnancy and its Laparoscopic Treatment.' In ectopic pregnancy, the baby grows outside the uterus, most commonly in the uterine tube. Pre-existing uterine tubes damage is a significant risk factor for ectopic pregnancy and about 50 per cent of ectopic pregnancies are associated with some degree of tubal disease due to pelvic infection, endometriosis, appendicitis, previous pelvic surgery, reversal of a tubal ligation, or fertility treatment. 

At times there is no obvious explanation for why an ectopic pregnancy has occurred. However, once a woman has had an ectopic pregnancy, she has a higher likelihood of having another one and should be monitored carefully if another pregnancy is attempted or suspected.

Surgical treatment of ectopic pregnancy historically requires a laparotomy using a skin incision. However, with advancements in laparoscopic surgery, the foetus can now be removed using two to three small, button-hole incisions. Following operative laparoscopy, patients are generally able to go home within 24 hours of surgery and recover more quickly at home, returning to full activities in three to seven days.

The presentations were followed by a question and answer session with the speakers which included Dr Lumaan Sheikh, Assistant Professor and Consultant Obstetrician and Gynaecologist.

As part of its outreach programme and societal commitment of creating awareness of early diagnosis and timely treatment, AKUH has organised over 230 ‘Signs, Symptoms and Care' programmes in Karachi , Hyderabad , Quetta and the UAE, benefiting more than 45,000 people.

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• Rasool Sarang, Sr Media Executive, at 486 3920;
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