Brief Answer:
Monitoring, maintenance and needed investigation.

Detailed Answer:
Hello,

Thanks for writing to us.

I can understand the amount of stress you are witnessing at this juncture and I shall try my best to help you. If you can furnish the details of the previous reports, kindly do the same.

At the outset, let me throw light on some of the causes of recurrent pregnancy loss or RPL along with helpful treatments in each case.
-chromosomal anomalies: analysis of the products of conception along with peripheral karyotypic analysis of the parents can be done. Genetic counselling is of help.
-presence of anti-phospholipid antibodies: Use of low dose heparin along with unfractionated heparin has been shown to help.
-anatomical defects like septate uterus, bicornuate uterus and so on, though rare as a cause of first trimester abortion, also should be considered. Surgery is possible in a few conditions like septate uterus, but is not helpful in the other conditions. Also, conditions like Asherman's syndrome, uterine fibroids and polyps may be suspected. IVF with a surrogate pregnancy remains the choice when an in-correctable anomaly exists.
-hormonal and metabolic disorders: untreated diabetes can cause abortions. Thyroid insufficiency and hyperprolactinemia can cause problems with sustenance of an early pregnancy. Proper supplementation in case of hypothyroidism and use of Bromocriptine in hyperprolactinemia is of help. Empirical treatment with progesterone can be of help sometimes.
-abnormal sperm patterns, psychological factors and habits like smoking, drinking, caffeine consumption and obesity have significant role.
-with so many reasons explained, 50-75% of couples have unexplained recurrent pregnancy loss.

Please continue with medication prescribed, get regular monitoring, avoid any kind of stress including intercourse and give her absolute bed rest until the spotting subsides. You can get the serum beta-hCG levels assessed on alternate days along with serial trans-vaginal/pelvic sonograms. A doubling titre along with a viable pregnancy is a positive sign. Please see that she is not stressed in any way as stress is not at all good for her pregnancy. Many-a-time, even though there is spotting during early trimester, pregnancies continue to term. So, please maintain a positive outlook.

Please consult a specialist in high risk pregnancies as this pregnancy is precious. That way your wife is likely to receive better care and support.

Hope I have clarified your query. Please feel free to contact if you need further clarifications. I will be happy to help.

regards,
Shanti.V.

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