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Had abortion due to lack of baby growth. Scan showed no residual tissues. How long should we wait for next baby?

Mar 2013
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Practicing since : 1998
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I got married in March 2013 and my LMP date was 31st May. At my dating scan my baby was 8 weeks and was due for NT scan on the 12th week (24th Sep) Unfortunately I had a missed abortion. A scan showed that my baby stopped growing at 9 weeks and I did not know untill I was 11 weeks. I was hospitalised for a D&C on 26th Sep however it happened naturally just few hours before the procedure. I was still wheeled in for a procedure to ensure my safety. A scan after few days showed that there were no residual tissues and was clear. What should I do now? How long should I wait? We both are in our early 30's and are not related. What precautions should I take? I was taking enough supplements, eating healthy and was on Susten 100 twice a day. Also I was travelling quite a lot for my work. I have no clue what caused the M/c but I would be dead than go through it again. The whole ordeal was traumatic and am still not over it.
Posted Mon, 4 Nov 2013 in Pregnancy
Answered by Dr. Aarti Abraham 47 minutes later
Brief Answer:

Detailed Answer:
Thanks for writing to us with your health concern.
Firstly, I can understand what you have gone through.
However, please understand that a lot of women go through a missed abortion, and it is not uncommon at all.
The most common reason for a missed abortion is a chromosomal abnormality in the baby, due to which it does not grow properly.
This is an accident of nature, and while the egg formation or the baby formation is occurring, a random error in the genetic arrangement , will result in such a picture.
Most such women will go on to achieve a successful pregnancy the next time around, as it is not at all necessary that such an event will recur.
Also you were very lucky that you did not need a D and C for evacuation.
So please do not live with such undue stress and anxiety.
However, I can understand your concern, and before attempting your next pregnancy, you should have a thorough work up to ensure that this does not happen again, particularly given your age.
Firstly, wait for atleast 3 - 6 months before planning your next conception .
Make sure that the following investigations are done, before planning your next baby -
1. Ideally and most important, chromosomal evaluation of the products of conception, obtained by D and C or by natural evacuation.
2 . Karyotype of you and your husband.
3. Blood group, viral markers, blood sugars, TSH of both partners.
4. Testing for antiphospholipid antibody syndrome - APA, ACA, ANA, LAC, bleeding profile etc.
5. Testing for thrombotic tendencies - Protein C, Protein S, Factor V Leiden mutation.
6. Detailed ultrasound scan ( 3 - D ) to rule out abnormalities in uterus or cervix.
Ideally hysteroscopy and laparoscopy should be done, but it is reserved for recurrent aborters.
7. Tests for hormonal imbalance - FSH, LH, AMH, prolactin.
8. Tests for infections - TORCH profile.
Some of these tests are quite expensive, and are suggested for women who have recurrent abortions. Since your age is advanced, and you are so anxious, I have listed all of them for you.
You can omit a few if you find them too costly.
After these tests are done ( if they are all normal ), then wait for 3 - 6 months.
Exercise regularly, eat healthy , avoid stress, take regular folic acid ( 5 mg per day ) tablets.
Plan your next pregnancy after 6 months, and take proper antenatal care, scheduling visits with a reputed gynecologist right from the time you are overdue by a few days.
All the best.
Please feel free to ask for further clarifications.
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