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Have had miscarriages. Cyst removed from uterus. Is there a chance of normal pregnancy?

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I have had 3-4 miscarriages. Also got removed cyst in uterus. 1st miscarriage in 2007 was prematurely born, did not develop proper hands and feet and was aborted and delivered normally as still born, was a boy. All other miscarriages were after few weeks itself. Last time got pregnant via ivf procedure in august 2011, but the baby did not develop heart beat even after 8 weeks so had to abort the baby. Now pregnant again 7-8 weeks. The usg showed baby to be very miniscule with not able to make out properly. Doctor advised to take blood test that showed erythrocyte sedimentation rate of 29 mm/hr, haemoglobin rate of 11.7 g/dl and Hematokrit rate of 36. Also Fibrinogen at 363 mg/dl. The doctor said the blood is thicker than normal, hence advised to take Lovenox injection.
Please let me know if above is normal and whether there is a chance of normal pregnancy here. whether taking lovenox after 7-8 weeks pregnancy will yield positive result. The injection has to be administered till 20th october, however will take usg scan on 13th oct. Please give your comments and advise based on the elaborative information provided. I am 41 and my husband is 40 years old. Thanks.
Posted Fri, 26 Oct 2012 in Pregnancy
Answered by Dr. Timothy Raichle 5 hours later
Hello, I would be happy to help you with your question today. Thank you for being patient while you waited for an answer.

With multiple unexplained first trimester losses, the approaches and consensus on how treat those patients differs and is controversial. It is not unusual to use a variety of medications in a patient such as you. These usually come down to progesterone supplementation and/or blood thinners and include:

1. Progesterone as a vaginal suppository twice daily from about 6 weeks to 10 weeks
2. Baby aspirin daily
3. Lovenox daily - often up until the third trimester

The labs that you have listed are likely normal for pregnancy, and do not indicate that your blood is "thicker". This would more likely be suggested by your history of multiple unexplained losses that those lab values.

With regard to the ultrasound, it may just be that the dates of the pregnancy are slightly off. If you were closer to 6-7 weeks, then the pregnancy would look much like you are describing. What is important is what it looks like at the followup scan on 10/13.

So in summary, I think that your labs are normal, the ultrasound does not indicate one way or the other whether this is a healthy pregnancy, and the use of Lovenox daily given your history of unexplained losses sounds reasonable and within the usual practice patterns of OB/GYN's taking care of patients with unexplained first trimester losses.

I hope this helps. Let me know if you have additional questions.
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