Brief Answer:
You need to undergo certain investigations

Detailed Answer:
Dear XXXX,

Your history suggests that your first pregnancy was normal and subsequently your pregnancy loss is at the earlier and earlier gestational period.

The first diagnosis that came to mind when I read pregnancy loss at 5 months was incompetent internal os of the cervix. However, the subsequent pregnancy loss was at little more that 2 months. Incompetent os never leads to abortion in first 3 months.

There are many more conditions for such pregnancy loss. To differentiate, will you please give me some information to start with :

1. What are your and your husband's ABO and Rh blood groups.
2. Your Thyroid function test reports : T3, T4 and TSH
3. Do you have any of the ultrasonography reports of all these lost pregnancies? You may please show the images to the ultrasonologist again and discuss the issue. Please inform me his/her views on them.
4. Were any of the lost product of conception subjected to histopathology study? That would have been of great help.

If you have got any of these reports with you, please upload the images and the reports for my review.

Regarding the current delay in the menses. Just 4 days after missing a period, pregnancy test on the urine may not be that reliably conclusive. So I would request you to wait for 4 more days and repeat the test on overnight first morning urine sample. Alternatively, you may opt for Beta hCG test immediately.

Whatever may be the status of pregnancy, please start Folic acid tablets daily 5 mg.. This helps the health of the growing baby. Also please report to Foetal Medicine specialist ASAP with the history and all the reports. Such consultant will be of more help than regular Obstetrician and Gynaecologist.

I hope this will; help you for the preliminary steps. After getting the information I have requested, we discuss the issue further.

For any more information, I am always available for you, XXXXX.

Dr. Nishikant Shrotri

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