Question: Hi Dr XXXXXXX I have been your patient at Columbia Asia, MRN# 100267. My name is XXXX I am 31 yrs old and 19 week pregnant, LMP 16 Nov 2013. I was under your guidance from before my present pregnancy to 14 weeks of pregnancy after which i travelled to US. Hope you remember me ! I have consulted a doctor here in US. I am unable to explain the doctor here why I was prescribed Ecospirin 75 - and she is not sure if this should be continued. I do not have BP or Sugar issues. My parents take BP medicines and have borderline sugar. She did Hoemocystin blood test on 22nd March here with result of 3.8umol/L. As of now i am continuing with Ecosprin. My brief medical history with values is mentioned after the following queries. 1)Can you please suggest if I should continue Aspirin, and for how long. Also, please suggest what I should explain to the doctor here on why I was prescribed Aspirin. 2)Please note I cant find Ecospirin here, and the closest thing is Bayer 81mg low dose saftey coated Aspirin - enteric coated tablet. Is that ok? 3)I would like to talk to you as well, can you please suggest phone no, date and time when I can call you - I cant find scheduling call on this site. My brief medical history is as below: Date of Birth: 15 Sep 1982 This is my second pregnancy .My first pregnancy was a missed miscarriage at 8weeks of conception identified at 12 weeks USG. Both pregnancies were on Clomid 150 under follicular monitoring.I was suspected PCOD earlier by my previous doctor but i discontinued its medication(metformin) after your advice(as AMH value was 1.77).I am following your prescription till today for my current (second) pregnancy. Current pregnancy(Second): LMP: 16 Nov 2013 Current medicines: Ecospirin 75, Adenosyl OD, Fol 123, 30mg Ferrous Ferrate (Orofer XT prescribed earlier and now finished), Calcimax, Vitamin D Tests AFTER pregnancy: TFT-N, Level1 Scan with NT-N, Double M screen Neg, HB-13, TPC-237, FBS-85, HPLC-N, Rubella-Immune Medicines BEFORE pregnancy: Eema D, Fertomid 150 , Folvite, Adenosyl OD 1000MCG Tests 1 month after Missed miscarriage of First Pregnancy, 6 May 2013: LH-1.81, FSH-6.77, E2-N, Insulin F and PP Insulin-N, Free Testo-N, DHAS-N, AMH-1.77, Torch - (Toxoplasma - IgG-9.3 & IgM-0.25, Rubella IgG-37.1 & IgM-1.08, Cytomegalovirus IgG-243.5 & IgM 0.49, Herpes IgG-0.22 & IgM-0.65) PT - (Mean Normal PT-13.2, Patient Value-13.7, PR-1.04, INR-1.05) APTT - Patient Value-37.8, Control Value-35.2 Vitamin D-39, Vitamin B12-451 First Pregnancy: LMP: 27 XXXXXXX 2013, IUD: 24 Apr 2013, CRL-17mm corresponding to 7wk 5d Medicinal Anomaly: Metformin stopped at 3 Mar could be cause of concern as per Dr XXXXXXX XXXXXXX - Consultant Clinical Genetics & Fetal Medicine Medicines AFTER pregnancy: Inj Proluton 500mg, Microgest 200mg vaginally, Folvite 5mg, Crocin 500mg Medicines BEFORE pregnancy: Clomid 150, Lopin 75mg, Metformin 500mg BD, Evion, Lymcee, Lycored, Folvite Tests before pregnancy: HSG-Normal, HVS-Sterile, Glucose F-70, E2-36, LH-4.1, FSH-3.9, PRL-10.3 Insulin (F)-19.9, TSH-0.78 I am attaching these and reports collated as excel sheet, showing values across diferent dates as well. Thanks a ton! XXXX

I remember before leaving for here, you've said Ecospirin will continue till 28wks and may be further. I am nervous about stopping it as of now, could there be any negative effect if I stop in-between the term of pregnancy? Would it help if I get any tests conducted before continuing / stopping this? I am absolutely open to get any tests done. Or if I should get any tests done now or later, if I discontinue it. Are you suggesting to stop because I've crossed first trimester, or is it because I am in US -- but I am still an Indian woman :) Thank you so much for your patience and advise!