Acupuncture, Miscarriage or Spontaneous Abortion

Spontaneous abortion, or miscarriage, is the loss of a fetus before 20 weeks of pregnancy. The most common cause of miscarriage is a genetic abnormality. A second miscarriage generally occurs in only 1% of women. However, there are women who experience habitual miscarriages (three or more consecutive spontaneous abortions). Almost one-third of miscarriages may occur as a late menstrual period, even before a woman knows for certain that she is pregnant.

Signs and Symptoms
Miscarriage is often accompanied by the following signs and symptoms:

Bleeding -- brown or bright red vaginal bleeding or spotting
Passage of clots or a gush of clear or pink vaginal fluid (may indicate pregnancy tissue from the uterus)
Abdominal pain or cramping
Decrease in signs of pregnancy, such as breast sensitivity and morning sickness
Dizziness, lightheadedness, or feeling faint

What Causes It?
A wide range of health conditions that affect at least one parent can cause a miscarriage, including the following:

1. Chromosomal abnormalities account for up to 60% of losses
2. Physical problems, such as distortion of the uterine cavity or adhesions from disease or surgery
3. Endocrine or hormone disorders, such as diabetes (when poorly controlled) and hyper- or hypothyroidism
4. Infection, including bacterial, viral, parasitic, fungal, or acquired through sexually transmitted diseases
5. Abnormal antibodies in the blood that cause formation of blood clots (for example, antiphospholipid antibodies, or APLA)
6. Other factors of conception (such as defective sperm cells, time of egg implantation), or stress

Who's Most At Risk?
People with the following conditions or characteristics are at risk for having a miscarriage:

Previous spontaneous abortion
Women age 35 or older
Cigarette smoking -- smoking half a pack or more per day significantly increases risk
Alcohol - -risk doubles with more than two drinks per day
Caffeine -- see section on Nutrition for more details
Cocaine use
X-ray exposure
Environmental toxins -- excessive exposure to lead, mercury, organic solvents
Serious maternal illness
Flight attendants working more than 74 hours per month
Maternal or paternal handling of anti-cancer agents
Increased levels of h***cysteine (see Nutrition section)

What to Expect at Your Provider's Office
If you think you are having a miscarriage, see your health care provider immediately. Your health care provider will take a comprehensive medical, family, and social history to try to determine if there is a suggestion of an underlying cause. A pelvic examination detects uterine abnormalities. Ultrasound imaging and other diagnostic and laboratory tests may help confirm diagnosis and to evaluate the condition of the uterus and fetus.

Avoid known risks, such as obesity, caffeine, alcohol, and cigarette smoking, as well as other risks listed above. A healthy body, with the immune and hormonal systems functioning properly, will help decrease the risks of a miscarriage.

Complementary and Alternative Therapies
There may be a strong connection among diet, lifestyle and risk of spontaneous abortion. Before becoming pregnant, it is a good idea to have counseling about the risks, including the importance of staying healthy and avoiding caffeine, alcohol, and recreational drugs. Also, some case reports suggest certain herbal medicines may help prevent recurring miscarriages caused by immune system problems.

Nutrition and Supplements
Following these nutritional tips may help reduce symptoms:

-Try to eliminate all potential food allergens, including dairy, wheat (gluten), soy, corn, preservatives, and food additives. Your health care provider may want to test for food sensitivities.
-Eat calcium rich foods, including beans, almonds, and dark green leafy vegetables (such as spinach and kale).
-Avoid refined foods such as white breads, pastas, and sugar.
-Eat fewer red meats and more lean meats, cold-water fish, tofu (soy), and beans for protein.
-Use healthy cooking oils, such as olive oil or vegetable oil.
-Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine
-Avoid coffee and other stimulants, alcohol, and tobacco.
-Drink 6 - 8 glasses of filtered water daily.
-Drink soy milk, for bone and hormonal health.
-Exercise moderately, as tolerated, 5 days a week.
-You may be able to address nutritional deficiencies with the following supplements:

A prenatal vitamin daily, containing the antioxidant vitamins A, C, E, the B-complex vitamins, and trace minerals such as magnesium, calcium, zinc and selenium. You should take at least 800 mcg of folic acid along with a B-complex vitamin during pregnancy. Ask your health care provider.

Calcium citrate, 1500 mg daily, in divided doses for bone support.

Vitamin D3, 400 IU daily, for bone support.

Omega-3 fatty acids, such as flaxseed and fish oils, 1 - 2 capsules or 1 tablespoonful oil two to three times daily, to help decrease inflammation. Cold-water fish, such as salmon or halibut, are good sources.

SAMe (s-adenosyl-L-methionine), 100 - 200 mg before breakfast daily, for mood improvement.

Probiotic supplement (containing Lactobacillus acidophilus ), 5 - 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. You should refrigerate your probiotic supplements for best results.

Coenzyme Q10, 100 - 200 mg at bedtime, for antioxidant and immune support.

Alpha-lipoic acid, 25 - 50 mg twice daily, for antioxidant support.

L-theanine, 200 mg one to three times daily, for stress and nervous system support.

Some herbs may help balance female hormones, help the immune system function more readily, and decrease stress. Work with your health care provider in order to determine which dietary supplements are right for you.

You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

Herbs that may help to reduce stress and aid in balancing the immune system include:

Green tea ( Camellia sinensis ) standardized extract, 250 - 500 mg daily, for antioxidant, anti-inflammatory and stress effects. Use caffeine free products. You may also prepare teas from the leaf of this herb.

Evening primrose oil ( Oenothera biennis ) standardized extract, 500 - 1000 mg daily, as a source of gamma linolenic acid (GLA), for symptoms of hormonal imbalance and stress.

Milk thistle ( Silybum marianum ) seed standardized extract, 80 - 160 mg two to three times daily, for detoxification support.

Many acupuncturists report success in treating women with a history of spontaneous abortion, leading to the ability to carry the pregnancy to full term. This may result from clearing up underlying endocrine problems and reducing stress. Acupuncture relaxes the uterus, increases blood flow to the uterus, warms the uterus, increases the immune system, regulates the hormones and decreases stress, all creating less of a chance of miscarriage.

If you had a spontaneous miscarriage without any prolonged bleeding, you will ovulate within two to four weeks after the miscarriage. Most miscarriages are complete, and if you did not have any infection symptoms (fever, discharge, excessive bleeding) after your pregnancy loss, it should not affect your attempts at becoming pregnant at all. You can start trying again once you have had two complete cycles.

The return of your normal cycles, and your chances of pregnancy, depend a lot on how far along you were when the miscarriage took place. In addition, you might want to keep track of any instrumentation, such as curettage, that you might have been exposed to or if there were any retained products after the miscarriage. Rarely, a small amount of placental tissue is left behind at the time of miscarriage. In this case, a woman may experience persistent bleeding along with a delay in the fall of hCG levels and the return to normal cycles.

I recommend that you take your basal body temperature or do cervical mucus monitoring to find out your most fertile period of ovulation. Herbal formulas and acupuncture can make a difference based on these criteria.

Acupuncture in IVF linked to lower miscarriage and ectopic rates
OB/GYN News, Jan 1, 2005

PHILADELPHIA -- Women who receive acupuncture during the stimulation phase of an in vitro fertilization cycle and again immediately after embryo transfer have a higher live-birth rate than do controls, according to the first acupuncture study with this end point.
"Other studies have looked at pregnancy rates, but what is really important is whether or not there is a baby," said Paul C. Magarelli, M.D., who reported his findings at the annual meeting of the American Society for Reproductive Medicine.

The retrospective study included 131 women who were undergoing standard in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). All of these women were considered good prognosis candidates for IVF/ICSI and were given the choice of having acupuncture.
There were no significant differences between the two groups in terms of infertility diagnoses, demographics, and treatment protocols, except that sperm morphology was slightly better in the partners of women receiving acupuncture (7.3% vs. 5.9% normal forms with strict criteria evaluation), and the average uterine artery pulsatility index was lower in the acupuncture group (1.57 vs. 1.72), said Dr. Magarelli of the department of ob.gyn. at the University of New Mexico, Albuquerque.

The study found that pregnancy rates per embryo transfer were not significantly different between the two groups (50% in the acupuncture group and 45% in controls).

The miscarriage rate was almost halved in the acupuncture group (8% vs. 14%).

In addition, the rate of ectopic pregnancies was significantly lower in the acupuncture group--0 of 24 pregnancies (0%) vs. 2 of 37 pregnancies (9%).

The live-birth rate per IVF/ICSI cycle was significantly higher in the acupuncture group than in controls (21% vs. 16%).

Andrew Pacholyk, MS, L.Ac
Therapies for healing
mind, body, spirit

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