Researchers unlock the mysteries of miscarriages with a blood test
Published on May 17, 2023 at 7:10 am
Better understand miscarriages and, in some cases, help prevent them: a team led by a Danish gynecologist has just shown that a simple blood test can better explain why a pregnancy fails.
Miscarriages affect one in ten women on average, and often more in countries where women are having children later and later. Miscarriages are traumatic events, the causes of which often remain unknown.
But the mystery rises little by little: Henriette Svarre Nielsen and her team have just published in the scientific journal “The Lancet” work to establish whether or not a miscarriage is due to a chromosomal anomaly. Contrary to what was previously accepted, the test can be used at the very beginning of a pregnancy, from the fifth week.
“If the pregnancy is terminated, we can take a blood sample from the mother to find out the genetic characteristics of the foetus,” explains Dr Svarre Nielsen. Until now, a similar test was only offered in Denmark after three consecutive miscarriages, if the pregnancy reached ten weeks gestation or more.
“We are in 2023, we must be beyond the simple number as a criterion determining an examination”, estimates the gynecologist. Thus, in Hvidovre, all women who have just had a miscarriage and have come to the emergency room are offered the test. More than 75% accept.
“For me, it was obvious to participate. It helps to understand, ”explains one of them, on condition of anonymity because she has not spoken of her miscarriage to all her relatives.
Investigate the causes
Isolated and then sequenced after the blood test, the DNA of the embryo or fetus is analyzed to determine whether it carries a significant and therefore non-viable chromosomal abnormality. The answer is positive in 50 to 60% of cases.
Thanks to this simple blood test, doctors “will see if certain chromosomes are more problematic than others. This will allow them to determine the risk in the future,” explains laboratory technician Lene Werge. In the absence of a chromosomal abnormality, the doctors’ careful investigation begins.
Hormonal imbalances, endocrine diseases, or even coagulation problems can explain an early termination of pregnancy. It is up to the doctors to determine the risks and to propose a treatment to avoid a recurrence.
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Launched in 2020, the project, entitled COPL, is still in progress and should make it possible to constitute a unique database, by bringing together different pathologies thanks to the largest cohort of women ever gathered.
“We will have a reliable database to correctly answer questions relating to miscarriages, reproduction, but also women’s health in general,” notes Svarre Nielsen.
Better prevention and management of miscarriages
A doctor for more than 20 years, she wants to change the practices of caregivers. “Miscarriages are something very common, they correspond to 25% of all pregnancies. Even if they are also frequent, for many, many years, we contented ourselves with emptying the uterus after the loss of pregnancy “without being interested in the mechanisms that caused it or the impact on the mental health of couples, deplores she.
Before having her two children, Rikke Hemmingsen had three miscarriages. Today, she is passionate about the project which “gives her hope that fewer women have to go through what we have gone through”. “It gives meaning to all the pain and sadness that every pregnancy loss is,” she says.
Often intimate dramas, miscarriages are rarely discussed in public and when they are, the reactions are sometimes clumsy. “Just because everyone says ‘it’s normal’ doesn’t make it any more normal or less sad for the person it’s happening to. But apparently, that encourages us not to talk about it” regrets the young woman.
This taboo can make access to adequate treatment more difficult. “We need to start talking about it more openly. Otherwise, how do you tell people that there are specialists in this country who can help you? asks this 39-year-old journalist.
Eventually, the results of the study could prevent 5% of the 30 million annual miscarriages in the world, according to Dr. Svarre Nielsen.