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Miscarriage. Done With TORCH Panel, CRP And Prolactin Tests. Taking Thyoronorm. Need Doctor Advise?
Question: Hello Doctor,
Greetings for the day !!
My wife suffered a miscarriage last month @ 7 weeks(1st Pregnancy). It was a natural one with no D&C required. Last week our local doctor advised 3 tests (a) TORCH Panel (2) CRP (3) Prolactin to be conducted and based on the findings, medicines were prescribed. I have attached the Test reports and subsequent prescription for your ready reference and advise. My queries are as under.
(a) Have we conducted the right test for understanding the reason for miscarriage?
(b) Does the results in TORCH makes it imperative to start the high powered antibiotic course, as advised by our local doctor? Is there any other options to look into prior to starting the course?
(c) Also the CRP is very high. Does it indents to high infection?
General Information
Name ; XXXX XXXXXXX
Age : 31(F)
Additional Information : On Thyoronorm (25 mcg) for the last 3 years. Non Diabetic. Weight : 81 kgs (5Ft 3"). Working Women.
Would be very happy to have in your expert views on the prescribed course(By Local Doctor) and any different approach in your views which needs to be implemented for better recovery.
Looking forward to hearing from you.
Best Regards
XXXX
Greetings for the day !!
My wife suffered a miscarriage last month @ 7 weeks(1st Pregnancy). It was a natural one with no D&C required. Last week our local doctor advised 3 tests (a) TORCH Panel (2) CRP (3) Prolactin to be conducted and based on the findings, medicines were prescribed. I have attached the Test reports and subsequent prescription for your ready reference and advise. My queries are as under.
(a) Have we conducted the right test for understanding the reason for miscarriage?
(b) Does the results in TORCH makes it imperative to start the high powered antibiotic course, as advised by our local doctor? Is there any other options to look into prior to starting the course?
(c) Also the CRP is very high. Does it indents to high infection?
General Information
Name ; XXXX XXXXXXX
Age : 31(F)
Additional Information : On Thyoronorm (25 mcg) for the last 3 years. Non Diabetic. Weight : 81 kgs (5Ft 3"). Working Women.
Would be very happy to have in your expert views on the prescribed course(By Local Doctor) and any different approach in your views which needs to be implemented for better recovery.
Looking forward to hearing from you.
Best Regards
XXXX
Hi XXXX
Thanks for asking on XXXXXXX
The tests which your wife has undergone are done to see the cause of miscarriage.The reports of these tests are indicator of old infection and not a new one. Ig G is an indicator of old infection and Ig M is an indicator of recent infection. So, old persisting antibodies may or may not require a treatment. For this, Ig G avidity test is available. If it comes out to be low then it indicates infection in last 5-6 months and will require treatment.
High CRP is an indicator of infection but a repeat test of CRP will clear the picture as if the value is decreasing then it indicates resolving infection.
Medicines prescribed by your doctor are good but for my patients, I used to get an avidity test or PCR before starting treatment.
Good Luck
Hope this information is helpful and informative to you.
If you had any further queries you can directly reach out to me on the following URL:
WWW.WWWW.WW
Thanks for asking on XXXXXXX
The tests which your wife has undergone are done to see the cause of miscarriage.The reports of these tests are indicator of old infection and not a new one. Ig G is an indicator of old infection and Ig M is an indicator of recent infection. So, old persisting antibodies may or may not require a treatment. For this, Ig G avidity test is available. If it comes out to be low then it indicates infection in last 5-6 months and will require treatment.
High CRP is an indicator of infection but a repeat test of CRP will clear the picture as if the value is decreasing then it indicates resolving infection.
Medicines prescribed by your doctor are good but for my patients, I used to get an avidity test or PCR before starting treatment.
Good Luck
Hope this information is helpful and informative to you.
If you had any further queries you can directly reach out to me on the following URL:
WWW.WWWW.WW
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doc,
Thank for your information.
So avidity test for the parameters which are positive in the TORCH test(As attached earlier) or for all the parameters.
Please advise. Also is avidity the common name in labs or any other names for me to communicate in a better way at the lab.
Also do I conduct the avidity test & another CRP first, before the start the prescribed medicines.
Regards
XXXX
Dear Doctor,
I would also like to know the cause/source of such infection in her.
Also should I also conduct some tests on myself to determine the source and what test are advised?
Thank for your information.
So avidity test for the parameters which are positive in the TORCH test(As attached earlier) or for all the parameters.
Please advise. Also is avidity the common name in labs or any other names for me to communicate in a better way at the lab.
Also do I conduct the avidity test & another CRP first, before the start the prescribed medicines.
Regards
XXXX
Dear Doctor,
I would also like to know the cause/source of such infection in her.
Also should I also conduct some tests on myself to determine the source and what test are advised?
Yes, avidity test for only positive reports is required.
You can ask for Ig G avidity test or if it is not available, PCR can also be done at a good lab.
I will suggest you to get these test first and then start the treatment.
Route of infection is usually respiratory,sexual or through contaminated saliva or urine.
Routine screening of sexual partner is not recommended. So, you need not to be investigated.
If you have any other query you can either send a follow up or directly reach to me on above mentioned URL.
You can ask for Ig G avidity test or if it is not available, PCR can also be done at a good lab.
I will suggest you to get these test first and then start the treatment.
Route of infection is usually respiratory,sexual or through contaminated saliva or urine.
Routine screening of sexual partner is not recommended. So, you need not to be investigated.
If you have any other query you can either send a follow up or directly reach to me on above mentioned URL.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
Greetings for the day !!
As advised by you, the avidity IgG tests for Toxoplasma and CMV was conducted and the reports has been attached for your kind reference. Please advice the next course of actions and medicines to start, based on the earlier prescription of my local doctor.
Is there any complications you find in the report? Please advice, as both of us are worried.
Dear Doctor,
Refer our telecon, I would kindly request you to go through the attached reports for proper validation and observation, even though I had tried to interpret the report to you during the telephonic discussion today.
Would look forward to your advice and way forward on this for future pregnancies.
Regards
XXXX
Greetings for the day !!
As advised by you, the avidity IgG tests for Toxoplasma and CMV was conducted and the reports has been attached for your kind reference. Please advice the next course of actions and medicines to start, based on the earlier prescription of my local doctor.
Is there any complications you find in the report? Please advice, as both of us are worried.
Dear Doctor,
Refer our telecon, I would kindly request you to go through the attached reports for proper validation and observation, even though I had tried to interpret the report to you during the telephonic discussion today.
Would look forward to your advice and way forward on this for future pregnancies.
Regards
XXXX
Brief Answer:
No need of treatment
Detailed Answer:
Hello, I have seen the attached reports.
As I discussed with you, with these reports, I will suggest you that your wife don't need a treatment as this report shows her to be infected with cytomegalovirus a long time back and not infected with toxoplasma. I will suggest you to discuss these reports with your treating doctor and then plan accordingly.
Good Luck.
Regards
Dr Deepti Goyal.
No need of treatment
Detailed Answer:
Hello, I have seen the attached reports.
As I discussed with you, with these reports, I will suggest you that your wife don't need a treatment as this report shows her to be infected with cytomegalovirus a long time back and not infected with toxoplasma. I will suggest you to discuss these reports with your treating doctor and then plan accordingly.
Good Luck.
Regards
Dr Deepti Goyal.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
We sincerely thank you for your continued advice and support during the last 8-10 days of our discussion. In fact, based upon your advice on avidity tests to be performed, we had derived at the actual prognosis of the infection and the way forward, to sanitize our anxieties.
Just to ensure, all is well post mis-carriage, do you recommend any other tests to be performed on her for better health and future smooth pregnancies.
Thank you once again for your guidance. You have been of tremendous help.
Best Regards
XXXX
We sincerely thank you for your continued advice and support during the last 8-10 days of our discussion. In fact, based upon your advice on avidity tests to be performed, we had derived at the actual prognosis of the infection and the way forward, to sanitize our anxieties.
Just to ensure, all is well post mis-carriage, do you recommend any other tests to be performed on her for better health and future smooth pregnancies.
Thank you once again for your guidance. You have been of tremendous help.
Best Regards
XXXX
Brief Answer:
No tests required
Detailed Answer:
Hi XXXX,
Your wife don't require any other further investigation.One or two miscarriages don't need any detailed investigation. Only if a patient has repeated miscarriages(>2), then we investigate her thoroughly.
Only thing you have to take care is her thyroid profile. Keep a check over it and consult a doctor as soon as she conceives again for thyronorm dosage modification.
If you have any further query, you can discuss with me on the above mentioned URL.
Good luck.
Regards
Dr Deepti Goyal
No tests required
Detailed Answer:
Hi XXXX,
Your wife don't require any other further investigation.One or two miscarriages don't need any detailed investigation. Only if a patient has repeated miscarriages(>2), then we investigate her thoroughly.
Only thing you have to take care is her thyroid profile. Keep a check over it and consult a doctor as soon as she conceives again for thyronorm dosage modification.
If you have any further query, you can discuss with me on the above mentioned URL.
Good luck.
Regards
Dr Deepti Goyal
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Doc.
We will stay in touch with you for future correspondences.
Thanks Again !!
Best Regards
XXXX
We will stay in touch with you for future correspondences.
Thanks Again !!
Best Regards
XXXX
Brief Answer:
Thanks
Detailed Answer:
Thank you so much.
I will always be happy to answer your queries.
Thanks
Detailed Answer:
Thank you so much.
I will always be happy to answer your queries.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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