Brief Answer:
EXPLAINED BELOW
Detailed Answer:
Hello
Thanks for writing to us with your health concern.
I have gone through the doctor's prescription.
It mentions a diagnosis of Antiphospholipid Antibody Syndrome.
That means that the tests cannot be all normal.
Can you please upload the tests done so far - so that I can go through them, and suggest any remaining ones ?
According to me with a history of 4 miscarriages , following workup is essential -
1. Chromosomal analysis of the products of conception of each miscarriage - also karyotyping of the husband and wife.
2.
Complete blood count, HIV , HBsAg, HCV, VDRL, for both partners.
3. Indirect Coombs test ( No need for this if you have been given Anti D injection for your negative blood group after each miscarriage ).
4. Screening for Rubella,
Toxoplasmosis.
5. TSH, Prolactin, FSH, LH, OGTT, DHEAS, Serum
testosterone, Lipid profile
6.
Semen analysis of husband
7. Testing for antiphospholipid antibody syndrome - APA, ACA, LAC, ANA, Aptt, Bleeding and clotting profiles
8. Serum
homocysteine levels and testing for MHTFR mutation, Protein C, Protein S.
9. Pelvic ultrasound scan / HSG to see size and shape of
uterine cavity.
10.
Thalassemia screening.
IF this much workup is done , and is normal, then this is unexplained recurrent abortion.
After the last abortion, please avoid conception for atleast 6 months ( now you can try for pregnancy ).
Take daily 5 mg per day folic acid before planning for pregnancy and continue till term.
For such patients, the drugs mentioned in the prescription also should be taken.
So Ecosprin 75 and Clexane 40 injections also should be taken from the day of confirmation of pregnancy till delivery.
Ecosprin prevents clotting of blood vessels and thus increases blood supply to the baby, and Clexane also has similar effect.
Meanwhile, at the earliest time that your periods are overdue, you should consult a reputed Obstetrician, get all antenatal testing done, and then start the prescription.
WIsh you all the best
Please feel free to discuss further.