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Had Miscarriage And Pregnant. Diagnosed With ALPA High And Reduced Diastolic Blood Flow In Left Uterine Artery. Will It Affect The Baby?

Posted on Mon, 11 Nov 2013

Question: Hi I am 29 old this is my 3rd prgncy previous two was miscarriage 1st one at 28 weeks due to high bp and 2nd was at 27 weeks due to unknown reason but after that diagnose with APLA high. Now on medication of ecoesprin 75 mg daily night and Exhep 60 mg (LMWH) SC daily morning with AlphaDopa 250mg 3 time daily. its 27th week running and gone for doppler usg and diagnose with reduced diastolic blood flow in left uterine atrtery with persustance diastolic notch in both uretine artery.
UTERINE ARTERY: RI: 0.59 RIGHT & 0.77 LEFT, SD RATIO: 2.4 RIGHT & 4.4 LEFT
UMBLICAL: RI: 0.68 & SD RATIO: 3.12
MIDDLE CEREBRAL : RI: 0.74 & SD RATIO: 3.89
BP : 130/80 LEFT HAND & 140/88 RIGHT HAND
Now plz sugest any precaution and extra medication as I am worry about my baby???

Answered by Dr. Dattaprasad (53 minutes later)

Brief Answer:
Frequent check ups necessary.

Detailed Answer:
Hi,
Welcome to XXXXXXX
Reduced diastolic flow & persistant diastolic notch in uterine arteries only indicate risk for pregnancy induced hypertension & small baby. As you are already taking treatment for the same (alphadopa, ecosprin & exhep) you need not worry.
As umbilical artery Doppler is within normal limits right now (meaning normal blood flow to the baby) there is no need to worry.
What you need is more frequent follow up, because whatever medicines you take is to reduce the risk of miscarriage, it never eliminates the risk.
You need good blood pressure control. Right now your blood pressure is fine.
The medicines you are taking are sufficient for risk reduction. Apart from medicines, you can take diet XXXXXXX in proteins (milk, soy floor & eggwhite if you are non vegetarian) & antioxidants (all fruits). Rest for 8-10 hours in left lateral position might help. Strict bed rest is not necessary.
Hope this is helpful.
Let me know if you have other concerns.
Regards.

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

Follow up: Dr. Dattaprasad (12 hours later)

Dear sir thanks for your kind advise
Is it safe and good to take 4-6 raw garlic cloves/bulb daily. I am also taking almonds, walnut, raisin, orange and honey with pomegranate, orange and XXXXXXX daily. Is it good to take protien like ceggs when I have the problem of blood cloting. kindly suggest you openion as i am attaching the CBC, PTINR, URINE ANALYSIS, DOPPLER USG Reports. please tell me that the readings of PTINR is normal as i am having APLA Blood cloating problem.....and is exhep (LMWH) dissolve existing cloats also.....?? My dr. Sugested me isoxsuprine cap and L-arginine also daily ......is it good...??? BP in left hand is 123/78 and in right hand 146/77 in evening and in aftrnoon left hand 114/76 , right hand 138/74. heart beat is always 115 avg.........is it an heart problem to me.

Answered by Dr. Dattaprasad (2 hours later)

Brief Answer:
Heart problem less likely.

Detailed Answer:
Hi,
Welcome back.
You can safely continue all the food items you are taking. Eating eggs doesn't aggravate clotting problem, you can safely continue eating the same.
As you are already taking exhep, clot formation is less likely. Exhep can dissolve already existing clots at higher (therapeutic) doses.
Your blood pressure readings are fine.
Regarding heart rate, isoxsuprine is known to increase heart rate. You can consult your physician to rule out any other cause for increased heart rate although its less likely.
Regarding your reports, I couldn't see any report attached. Kindly reupload the same for further advice.
Regards.

Above answer was peer-reviewed by : Dr. Yogesh D