Brief Answer:
IgG indicates exposure and IgM indicates infection

Detailed Answer:
Hello,

Thanks for your query.

I would like to know some information before I can comment any further. Please let me know the exact cause of the two unsuccessful pregnancies, if there was an autopsy of the fetuses and if there were any complications during pregnancy. Also, please let me know the exact lab values and the reference range.

IgG indicates exposure to infection sometime in the past while IgM indicates present infection. Rubella is a one-time infection and once exposed will give life-long immunity. CMV can be a repeated infection.

Please let me know the details so I can help you.

regards,
Shanti.V.

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Brief Answer:
Treatment is not necessary.

Detailed Answer:
Hello,

Thanks for writing back.

As there is no IgM positive reaction, there is no infection at present and as such, no treatment is necessary. The test can be repeated after two or three weeks to see if the titres are raised and this is suggestive of a recent infection. Apart from this, immunity is almost always conveyed by a single rubella infection and there is no further chance of infection unless severe immunodeficiency arises. While with CMV infection, there is sometimes a chance of re-infection.

Small stomach bubble can happen with gastro-intestinal malformations. If it is a correctable cause like esophageal atresia, it can be cured by surgery at birth. The extent of the malformation determines the course of treatment. In most cases, the cause is unknown. An MRI would be of help in doubtful cases as is a high resolution ultrasound. I would also suggest genetic counselling before embarking on the next pregnancy.

Use of prenatal folates can help in preventing anomalies. Please get a complete pre-natal assessment by an experienced gynecologist.

Hope I have answered your query. Please contact for more information. I will be ready to help.

regards,
Shanti.V.

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Brief Answer:
Three cesarean deliveries are safe.

Detailed Answer:
Hello,

Thanks for writing again.

I can understand your anguish and completely agree with you. It is true that a maximum of three cesarean deliveries can be safely allowed in a woman. This leaves your wife with another chance.

Going by the obstetric history, there appears to be no recurrent cause for the pregnancy loss in the second pregnancy while the first loss was unfortunate after having a normal baby at birth. Yet, I would ask you to see an expert in high risk pregnancies in view of the importance the next pregnancy holds for you.

Several tests should be done before contemplating another pregnancy. Some of them are- genetic screening, Rh antibody testing, test for anti-phospholipid antibodies, couple karyotyping etc. If the aborted fetus in the second pregnancy had an autopsy and the cause of the defect noted, it would be very helpful.

Intake of folates, relief from stress as much as possible, sufficient rest and good diet help a lot during the preparatory phase. Even after conception under surveillance, regular investigation to notice any defect developing in the baby is necessary. Most often, proper planning results in successful outcomes.

Hope all your queries are answered. Please contact if you need any more information. I will be ready to help as best as I can.

Wish you good health.

regards,
Shanti.V.

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