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Had Miscarriage, Feotus Had Triosomies. Pregnant And Advised Susten And Folasia After HCG Test. Suggest?

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Posted on Thu, 25 Jul 2013
Question: I am 29 years old I had a miscarriage in feb , the feutus had triosomies according to foetel report
My husband and mine Karo typing and torch and other tests are ok , I am six week pregnant now
My HCG level is 2750 , doctor advised susten 200 at night and folasia , she said no other required and ultrasound on 15th July , my other Doctor is saying take colsprin , folic acid , endogest twice and dupasthol twice and ultra sound after 10 days which advise should u follow
doctor
Answered by Dr. Dr. Ahmed Bahaa (2 hours later)
Hi,

Welcome to XXXXXXX

Both doctors are right. Folic acid is an essential supplement in the first trimester as it prevents neural tube defects and other anomalies. Progesterone is a good support to pregnancy in some cases (not in your case but there is no harm). Aspirin is useful in some cases of repeated pregnancy loss (also not in your case but there is no harm).

If it was me I would only suggest Folic acid, but as I said the other drugs will not harm.

As for the ultrasound, the pregnancy should be visible by the transvaginal ultrasound at this stage, or after one week or ten days by the abdominal probe.

Presence of trisomy in a previous baby while both parents are normal means that this was incidental and no repetition is expected, so I wish you a successful pregnancy this time ending in a healthy beautiful baby.
I wish, I have answered your query and will be happy to answer more questions from you.

Good luck.
Dr. Ahmed Bahaa.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Ahmed Bahaa (2 hours later)
Thanks doctor , can u advise that which progesterone should I take susten or dupasthoal and endogest ,

Also are the HCag levels ok , and when should I get ultrasound , around 5th
As I am more comfortable with abdominal one
doctor
Answered by Dr. Dr. Ahmed Bahaa (3 hours later)
Hi, happy to answer you again.
All progesterones are good but the vaginal or rectal route is more potent than the oral.
The HCG level is very good and no need to be repeated.
You may have an abdominal scan after one week or ten days.
I am interested to know the results of your scan and to answer any more queries.
Good luck.
Dr. Ahmed Bahaa.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Ahmed Bahaa (23 minutes later)
Thanks Doc will def let u know , one fix has suggested bed rest other has said take it lightly , also I sleep on my side is it ok , and breasts have enlarged , mouth feels metallic and with salvia and i get burps after eating but feel nausea but I have not vomited is it normal
doctor
Answered by Dr. Dr. Ahmed Bahaa (4 hours later)
Hi, thank you for these questions.
It seems that your doctors are taking extra precautions with you as they advise you bed rest, just like the extra drugs you are taking.
The aim is to avoid straining (cough, constipation, lifting heavy objects, intercourse). Resting in bed all day is not good. There must be some movement.
You can sleep at any position you feel comfortable with.
Breast enlargement is a normal physiological change.
The metallic taste, burps, nausea and even vomiting are all normal, indicating a stable and healthy pregnancy. Your doctor may prescribe you symptomatic treatment for these if you cannot bear them (antacids and antiemetcs).
Writing to answer more queries from you.
Good luck.
Dr. Ahmed Bahaa.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dr. Ahmed Bahaa (6 days later)
Hi doc , thanks a lot for ur earlier replies , in continuation I had my blood tests and in that PT T LA value is 48 , so doc has said that ecosprin is very imp so should I start eating , also everything else is fine my scan is on 6th , hope I don't need any hcG infections or anything
Also does it mean at high level that is 48 , ecosprin should be taken
The ref value in lab test is given as 31-45
doctor
Answered by Dr. Dr. Ahmed Bahaa (5 hours later)
Hi again.

Positive Lupus anticoagulant and anticardiolipn antibodies, together with a history of repeated pregnancy loss is a diagnosis of APAS (antiphospholipid antibody syndrome).

It is not necessary to go in depth in this syndrome but it's recognized treatment is low dose aspirin together with heparin. Also corticosteroids may have a role.

From your history you do not have APAS, and we cannot rely on a single investigation.
The previous abortus was trisomic and not related to APAS.

My advice is not to worry and continue on your treatment.

I am still interested to know the results of your ultrasound scan and your routine labs.

Good luck.
Dr. Ahmed Bahaa.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Ahmed Bahaa (38 minutes later)
Ultrasound is on 6th doc and all other lab tests are ok , only as stated above PTT value is higher , so my question is. Should I take asprin as my doc said does higher value mean thinning of blood is required
Let me know which other values I can tell u rest all are within range
doctor
Answered by Dr. Dr. Ahmed Bahaa (2 hours later)
Hi,
It's good to know that your ultrasound is ok.
The values I need to know are:
Hb level
PT, PTT, INR
Platelet count
Fasting and 2 hours blood sugar after 100 gm glucose load (or any other test to screen for diabetes)
Rubella IGg level
urine analysis
Optional tests include screening for hepatitis B,C and HIV.
also the ultrasound report for accurate calculation of dates and to estimate the due date (CRL)
Thank you.
Dr. Ahmed Bahaa.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Ahmed Bahaa (13 hours later)
Hi Doctor here are the values

HB Value :12.60
Platlet Count : 298.0
Sugar : non fasting : 109
Rubella IGG level : 15.70 ref :less than 10
In urine analysis only epithelial cels are ++( in fair nos) rest is normal according to ref range
Negative for hep B , C and HiV

Partial thromboplastin time , activated , 29.10
Patient value and control value :27.45
Partial thromboplastin time Lupus that is PtT LA is 48.80 , range 31.40 - 43.40
I have not had ultrasound yet it will happen on 6th July
My Question is should I take asprin 75 mg as advised by my doctor

doctor
Answered by Dr. Dr. Ahmed Bahaa (2 days later)
Hi, sorry for being late.
I am happy to know these results. All the results are reassuring. your Hb is perfect, also your blood sugar level.
You don't have rubella I.e. no fear of exposure.
I advise you to continue on your treatment including aspirin.
waiting for your ultrasound report.
Dr. Ahmed Bahaa.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Dr. Dr. Ahmed Bahaa

OB & GYN Specialist

Practicing since :2000

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Had Miscarriage, Feotus Had Triosomies. Pregnant And Advised Susten And Folasia After HCG Test. Suggest?

Hi,

Welcome to XXXXXXX

Both doctors are right. Folic acid is an essential supplement in the first trimester as it prevents neural tube defects and other anomalies. Progesterone is a good support to pregnancy in some cases (not in your case but there is no harm). Aspirin is useful in some cases of repeated pregnancy loss (also not in your case but there is no harm).

If it was me I would only suggest Folic acid, but as I said the other drugs will not harm.

As for the ultrasound, the pregnancy should be visible by the transvaginal ultrasound at this stage, or after one week or ten days by the abdominal probe.

Presence of trisomy in a previous baby while both parents are normal means that this was incidental and no repetition is expected, so I wish you a successful pregnancy this time ending in a healthy beautiful baby.
I wish, I have answered your query and will be happy to answer more questions from you.

Good luck.
Dr. Ahmed Bahaa.