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History of miscarriage. Pregnant. Blood work showed thicker blood then normal. Chances 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.

The latest scan yesterday showed slight increase in size of the feutus but still could not make out properly and there was no heart beat either. The doctor said will do the usg again on 19th october and will ascertain the status of the baby.

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 and next scan as informed earlier is on 19th october. Please give your comments and advise based on the elaborative information provided. I am 41 and my husband is 40 years old. Thanks.
Posted Tue, 30 Oct 2012 in Pregnancy
Answered by Dr. Timothy Raichle 4 hours later
Hello, I would be happy to help you with your question!

I have helped you with your prior questions, but I see that since that time, you have had a followup ultrasound. Assuming that you are certain about your last period and/or when you conceived, you are stating that you should be 7-8 weeks along. At the last scan, they did not comment on the heart beat, BUT they could make out the fetus.

On the current scan, especially the possibility that you are slightly off on your dates for the pregnancy, you must be at least 6-7 weeks. The earliers that you can see a heart beat is about 6 weeks, but definitely by 7-8 weeks. Given the small amount of interval growth and the inability to see the heartbeat, this does not sound like good news (just to be honest).

In answer to your question "is there a chance of normal pregnancy?", given your history, current gestational age, and inability to see the fetal heart beat, I think this sounds similar to your other pregnancies. I agree that the scan on 10/19 makes sense, but I have concerns that this is a probable miscarriage.

The Lovenox is of little harm at this point, and there is concern that you are predisposed to miscarriage, so this is not an unusual treatment regimen. Assuming that this is a miscarriage again, there needs to be an honest and thorough review of your history and whether there are additional labs that need to be done. These labs would include a karyotype, or genetic studies, on both you and your husband. In addition, given the prior "cyst" in the uterus, a followup ultrasound of your uterus when you are not pregnant is also indicated.

I am sorry that you are going through such a difficult time! It is hard to wait, but it is largely out of your control. Please let me know if you have any more questions.
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