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Suggest Precautionary Measures To Avoid Miscarriage
Question: hello Doctor,
Hope you're doing good.
I have consulted with you earlier as well regarding my miscarriage which happened during my first pregnancy at 19 weeks.
All my test reports were normal except the one for CMV virus , which showed the IgG levels were high.
But I am still not sure of the real reason of my miscarriage.
Another reason which was mentioned by my doctor at the time of miscarriage was cervical incompetence, but then I had the complete ultrasound & scanning done which showed that the Cervix is normal.
It is now 1 year since all this happened & I am planning for the pregnancy again.
But before that I wanted to consult you if I should undergo any tests/medications in order to avoid such an unfortunate incident again.
My health, height, weight are all normal.
I always had irregular periods which became regular after my miscarriage for few months but now again the periods are delayed by 8-10 days.
I have also observed that before I conceived for the first time, my periods used to last for 6-7 days but now they get over within 4 days with reduced bleeding.
I am not sure if that is normal.
Please suggest if there is anything which I should be taking care of before I plan to conceive again.
Please let me know if any other details are required from my end.
Thanks in advance.
Regards,
xxxxxx
Hope you're doing good.
I have consulted with you earlier as well regarding my miscarriage which happened during my first pregnancy at 19 weeks.
All my test reports were normal except the one for CMV virus , which showed the IgG levels were high.
But I am still not sure of the real reason of my miscarriage.
Another reason which was mentioned by my doctor at the time of miscarriage was cervical incompetence, but then I had the complete ultrasound & scanning done which showed that the Cervix is normal.
It is now 1 year since all this happened & I am planning for the pregnancy again.
But before that I wanted to consult you if I should undergo any tests/medications in order to avoid such an unfortunate incident again.
My health, height, weight are all normal.
I always had irregular periods which became regular after my miscarriage for few months but now again the periods are delayed by 8-10 days.
I have also observed that before I conceived for the first time, my periods used to last for 6-7 days but now they get over within 4 days with reduced bleeding.
I am not sure if that is normal.
Please suggest if there is anything which I should be taking care of before I plan to conceive again.
Please let me know if any other details are required from my end.
Thanks in advance.
Regards,
xxxxxx
Brief Answer:
As below
Detailed Answer:
Hello XXXXXXX
Yes, I am doing good.
Hope you are fine too.
I have gone through the details of all our previous consultations.
I told you not to worry about the CMV virus testing, since high Ig G levels are non specific, and no treatment is required for that.
Also, the reason was not determined for the miscarriage, but cervical incompetence seemed more likely.
Your pelvic scan mentioned the cervix was normal.
Also, karyotype ( chromosomal test ) of the aborted baby was essential, but I remember you said that it was missed out.
I recommended hormonal tests ( FSH, LH, TSH, Prolactin, OGTT ) - you said they were done, and normal.
Those are the tests needed for irregular cycles too.
If they are normal , there is no need to worry.
Also, your antiphospholipid antibody tests were normal.
In my opinion, all tests that are required have been done, nothing remains.
I have just a few pointers for you before you start planning for a child again -
1. Please let me know your current height and weight.
2. Your current blood pressure .
3. Please take folic acid 5 mg per day ( folvite one tablet daily ) for atleast a month before starting to plan a child.
4. Get your fasting and post prandial blood sugar, hemoglobin, TSH and urine routine checked before planning for a child . To summarize -
Hemoglobin ( Hb )
TSH
FBS
PPBS
Urine routine microscopy and urine culture test.
These are baseline tests and will help in comparison later on in pregnancy
5. What is your blood group ?
6. Where do you reside, and whom do you intend to consult when you conceive ?
It is very vital to have a cervical tightening ( encirclage ) stitch around 4 weeks before the miscarriage.
In your case, please have it done around 14 weeks of pregnancy.
That is the most critical step.
I hope this information has helped you.
Looking forward to hearing from you.
Have a joyful 2016 !!
As below
Detailed Answer:
Hello XXXXXXX
Yes, I am doing good.
Hope you are fine too.
I have gone through the details of all our previous consultations.
I told you not to worry about the CMV virus testing, since high Ig G levels are non specific, and no treatment is required for that.
Also, the reason was not determined for the miscarriage, but cervical incompetence seemed more likely.
Your pelvic scan mentioned the cervix was normal.
Also, karyotype ( chromosomal test ) of the aborted baby was essential, but I remember you said that it was missed out.
I recommended hormonal tests ( FSH, LH, TSH, Prolactin, OGTT ) - you said they were done, and normal.
Those are the tests needed for irregular cycles too.
If they are normal , there is no need to worry.
Also, your antiphospholipid antibody tests were normal.
In my opinion, all tests that are required have been done, nothing remains.
I have just a few pointers for you before you start planning for a child again -
1. Please let me know your current height and weight.
2. Your current blood pressure .
3. Please take folic acid 5 mg per day ( folvite one tablet daily ) for atleast a month before starting to plan a child.
4. Get your fasting and post prandial blood sugar, hemoglobin, TSH and urine routine checked before planning for a child . To summarize -
Hemoglobin ( Hb )
TSH
FBS
PPBS
Urine routine microscopy and urine culture test.
These are baseline tests and will help in comparison later on in pregnancy
5. What is your blood group ?
6. Where do you reside, and whom do you intend to consult when you conceive ?
It is very vital to have a cervical tightening ( encirclage ) stitch around 4 weeks before the miscarriage.
In your case, please have it done around 14 weeks of pregnancy.
That is the most critical step.
I hope this information has helped you.
Looking forward to hearing from you.
Have a joyful 2016 !!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
hello Doctor,
Thanks for your quick response as always :)
I will get these tests, which you have suggested, done within this week.
My height is 5'2" and my weight is around 60 kgs.
Last time, around a month ago, when i had my blood pressure checked, it was normal but i will get it checked again too.
My Blood group is B+.
I stay in XXXXXXX & right now i have not decided on whom to consult with when i conceive again as we dont have any family doctor here.
Please do suggest if you have any known Dr. here in XXXXXXX
Regards,
xxxxxxx
Thanks for your quick response as always :)
I will get these tests, which you have suggested, done within this week.
My height is 5'2" and my weight is around 60 kgs.
Last time, around a month ago, when i had my blood pressure checked, it was normal but i will get it checked again too.
My Blood group is B+.
I stay in XXXXXXX & right now i have not decided on whom to consult with when i conceive again as we dont have any family doctor here.
Please do suggest if you have any known Dr. here in XXXXXXX
Regards,
xxxxxxx
Brief Answer:
As below
Detailed Answer:
Hi XXXXXXX
Thank you for your appreciation.
I do not know anybody personally in XXXXXXX I am so sorry.
There are some excellent hospitals in XXXXXXX such as Cloud Nine hospitals.
You can contact somebody known to you personally over there.
Take care, and let me know when the tests are done.
Take care.
As below
Detailed Answer:
Hi XXXXXXX
Thank you for your appreciation.
I do not know anybody personally in XXXXXXX I am so sorry.
There are some excellent hospitals in XXXXXXX such as Cloud Nine hospitals.
You can contact somebody known to you personally over there.
Take care, and let me know when the tests are done.
Take care.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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