During the past 20 years, Dr Eric Daiter has successfully helped thousands of couples that have suffered through the grief and emotional trauma of a pregnancy loss. If you have questions about miscarriage or you just want to find a compassionate infertility specialist to guide you, Dr Eric Daiter would be happy to help (in his Edison, NJ office or on the telephone). It is easy, just call us at 908 226 0250 to set up an appointment (leave a message with your name and number if we are unable to get to the phone and someone will call you back).
"I always try to be available for my patients since I do understand the pain and frustration associated with fertility problems or endometriosis."
"I understand that the economy is very tough and insurance companies do not cover a lot of the services that might help you. I always try to minimize your out of pocket cost while encouraging the most successful and effective treatments available."
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The unusual causes for recurrent pregnancy loss that are not included in other sections include:
Debilitating maternal disease states
Substance abuse with either heavy smoking, alcohol or drug abuse
Irradiation or exposure to chemical toxins
Medications known to be teratogenic.
Any life threatening maternal disease can compromise reproductive performance either through an ovulatory dysfunction or immunologic disorder.
Women with insulin dependent Diabetes Mellitus who are in poor control have a greater spontaneous abortion rate while those in good control most likely do not have an increased rate. The glycosylated hemoglobin level is a reasonably good assessment of longer term control, and several reports agree that spontaneous abortion rates increase as the glycosylated hemoglobin becomes increasingly abnormal (especially when greater than 3-4 standard deviations over the mean).
Substance abuse is associated with spontaneous abortion. Cigarette smoking is associated with an increase in chromosomally normal spontaneous losses, implying a direct effect on the fetus. Alcohol abuse has been associated with spontaneous abortion if in high quantities, but results within this literature on alcohol are occasionally conflicting (generally excessive consumption is drinking at least 2-3 times per week). Illicit drug abuse affects ovulation and can result in an ovulatory dysfunction. Little is known about the early effects of these drugs on pregnancy and their association to spontaneous abortion.
Industrial or environmental toxins associated with recurrent pregnancy loss include arsenic, benzene, ethylene oxide, formaldehyde, and lead. There has been a concern especially among health care professionals regarding anesthetic gases and miscarriage, with mixed findings in the literature making it prudent to avoid routine intense exposure if possible. Irradiation during diagnostic studies with a total exposure of less than 10 rads is thought to confer only a small increase in risk of spontaneous abortion.
Medications taken during pregnancy should be reviewed with an obstetrician. The current understanding of the effect of drugs on pregnancy include:
From the time of conception (about day 14 of a 28 day cycle) until about 2 weeks later (31 days gestation in a 28 day cycle) harmful effects of drugs typically have an “all or none” effect on pregnancy. This means that if there is a damaging effect then the pregnancy is generally lost while if the pregnancy goes on then there are typically no anomalies.
The classic teratogenic period is from 31 days gestation (in a 28 day cycle) to 71 days gestation (about 10 weeks gestation), during which time damage can occur to specific organs as they form and fetal anomalies may result.
After the classic teratogenic period there is still significant development of the brain, which is possibly affected by medications
The FDA (Food and Drug Administration) uses 5 categories of labeling for drugs in pregnancy, including
“A”: controlled studies in women fail to demonstrate a risk to the fetus in the first trimester, and the possibility of fetal harm appears remote
“B”: animal studies do not indicate a risk to the fetus and there are no controlled human studies, or animal studies do show an adverse effect on the fetus but well controlled studies in pregnant women have failed to demonstrate a risk to the fetus
“C”: studies have shown the drug to have animal teratogenic or embryocidal effects, but no controlled studies are available in women or no studies are available in either animals or women
“D”: positive evidence of human fetal risk exists, but benefits in certain situations (eg., life threatening situations or serious diseases for which safer drugs cannot be used or are ineffective) may make use of the drug acceptable despite the risk
“X”: studies in animals or humans have demonstrated fetal abnormalities, or evidence demonstrates fetal risk based on human experience, or both and the risk clearly outweighs any possible benefits