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Dr. Andrew Rynne

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Can anxiety, travelling cause an abortion?

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Dr. Aarti Abraham

OBGYN

Practicing since :1998

Answered : 5999 Questions

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Posted on Thu, 7 Feb 2013 in Pregnancy
Question: This question is on possible reasons for expired baby in beginning of sixth month.

Nothing is suspectable in Double marker and all other tests performed in 3rd month.

My wife and me went for a normal checkup in 6th month on 24th DEC 2012(went directly to Ultrasound test as it is due in 6th month). Came to know from Ultrasound test that baby's heart beat was not visible. We went for a second opinion and there also we got same response.

Normal Abortion has been done after admitting my wife in hospital on same day. Now My wife is ok, from her health point of view.

Only question bothering us is why his has happened to us.

Below are the activities that she has done before we came to know this news.

One month before, she got exited due to family/personal situation then shouted and fell down (on 27th November).
On 8th December she traveled to Bangalore by train on job purpose (she is working from home, still need to visit office i Bangalore atleast once in a month).

Observation: I heard some sort of sound from her stomach before 8th December (after 2 Hr of having dinner). In addition, visited doctor before traveling to Bangalore (i.e. before 8th December) and doctor told that every thing is ok (by manually placing steth/hand on my wife stomach)

My wife returned from Banglore on 22nd December by train. but this time as she didn't get lower XXXXXXX in the train managed with the side upper XXXXXXX

She never felt any symptoms like Back pain or bleeding or fever. so she never felt that some thing is happening.

Could you please suggest what type of test we need to undergo to avoid this situation further. And what might be the root cause of this issue?
doctor
Answered by Dr. Aarti Abraham 47 minutes later
Hi XXXXXXX
Thanks for writing to us.
I will briefly let you know what causes could cause the death of the fetus inside the uterus.

1. Birth defects and fetal abnormalities, chromosomal disorders, specially undiagnosed cardiac anomalies might cause sudden fetal death. Was an anomaly scan done in your case ? Also, please note that the double marker as well as the anomaly scan cannot identify 100 % of abnormalities in the baby. A detailed fetal autopsy and examination of the placenta is a must. I hope that was done too after the termination of the pregnancy.

2. Severe growth retardation / oligohydramnios ( decreased amount of amniotic fluid around the baby ) - these too can lead to fetal demise. It can be diagnosed by examination by the obstetrician and confirmed by serial ultrasounds and Color Dopplers if required.

3. Maternal diseases such as raised blood pressure, diabetes, renal disease etc - these also can be picked up if she was on regular antenatal check up, and all investigations had been done.

4. Placental bleeding or abruption - Not all bleeding is revealed from the vaginal tract. In abruption, a silent bleed goes on behind the placenta, causing fetal death. In particular, as you mentioned that she had a fall and mental excitement, I hope that a check up after that incident revealed no abruption and no increase in her blood pressure. Trauma is one cause of placenta abruption.

5. Rh blood group incompatibility , thalassemia , certain infections etc like cytomegalovirus, rubella, parvovirus etc cause fetal death in uterus. A detailed fetal autopsy after delivery would reveal the case .

6. Intrahepatic cholestasis of pregnancy - a condition characterized by deranged liver function tests , mild jaundice and itching - is notorious for causing sudden intra uterine death of fetus.

7. Cord accidents - cord prolapse, cord cysts, hematomas, cord entanglements, knots in the cord, and placental abnormalities also cause fetal death. These are also shown on autopsy.

8. Maternal smoking/drinking/consumption of certain drugs/ teratogenic medications - all can cause sudden fetal death.

9. Some rare autoimmune diseases and conditions like antiphospholipid syndrome.

Also sometimes, no known cause can be identified when it is called idiopathic.

The tests I would suggest for you are :

1. Complete fetal autopsy and detailed examination of the placenta and membranes
.
2. Systemic check up of your wife - including blood pressure, BMI, heart, lungs , pelvic check up for any uterine abnormality , blood sugars, thalessemia screening, thyroid hormonal profile, oral glucose tolerance test, renal and liver function tests, screening for rubella and other infectious diseases, blood group , cross matching, testing for antiphospholipid antibody syndrome.

3. Karyotyping of both parents for any obvious genetic defects.

4. Certain coagulation tests like Protein C, Protein S, Factor V Leiden mutation, homocysteine levels - which might have caused placental blood clots and obstructed blood supply to the baby.

In fact, you should ideally have a consultation with a Fetal Medicine and Genetics Specialist to evaluate you completely, prepare a pedigree and identify the risk factors present in the couple, and guide you accordingly for the tests also.

None of the other facts that you mentioned seem to be contributory to the catastrophic event you had .

Please go through this link - particularly the checklist following fetal death. I hope it would add to your understanding :

WWW.WWWW.WW

My best wishes for the future , and feel free to ask for any further clarifications.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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