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Dr. Andrew Rynne

Family Physician

Exp 50 years

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How is medical management of miscarriage done?

My husband and I learned today that I ve had a miscarriage. We tried to ask the staff at the early pregnancy unit that I needed a scan 2 days ago when I started to notice some bleeding but just advised me to monitor myself at home. We eventually convinced the unit to scan me today and learned that I have to make a decision what management to take. I am still confused. I am a healthy woman with no other health issue apart from being 40 and almost everyone in my family and close friends seems to imply that the best option is the surgical management. I ve never had any surgical procedure or anaesthesia. I am scared. Please give me advice.
Mon, 10 Sep 2018
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OBGYN 's  Response
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.

Medical management includes induction of an abortion using medication under medical surveillance. Prior sonogram to locate the gestation sac and the age of the pregnancy. blood counts and urinalysis are done. The procedure can be done until 8 weeks of pregnancy with good results. Follow up is done after two weeks to check for any retained products of conception and this includes a clinical evaluation and a sonogram of the pelvis. You can plan depending on the age of your pregnancy and the available medical facility.

Hope I have answered your query. Let me know if I can assist you further.
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General & Family Physician Dr. Shinas Hussain's  Response
Hi,

You can consult a gynecologist and take drugs like Misoprostol and Mifepristone. These are prescription drugs and you can not avail it over the counter.

Hope I have answered your query.
Let me know if I can assist you further.
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History : My sister (Age 32) under gone three repeated miscarriages • First miscarriage happened in 2nd month • Second miscarriage happened in 4th month • Third miscarriage happened in 4th month After third miscarriage we undergone some of the tests suggested by the doctor and below are the details Date : 28 July 2010 Tests undergone first time after three miscarriages Lupus Anticoagulant 1 (Screen) 53 sec (Normal 28-45) Lupus Anticoagulant 2 (confirm) 58 sec (Normal 28-40) Ratio (LA1/LA2) 0.91 ( 1.3 Normal) A.P.T.T TEST 38 sec (result) (Normal 30-40 sec) CONTROL 24 sec (result) (Normal 30-40 sec) ANTI CORDIOLIPIN ANTIBODIES CARDIOLIPIN ANTIBODY – lgM 9.67 PL-lgM-U/mL ( 10 : Negative) CARDIOLIPIN ANTIBODY – lgG 28.0 PL-lgG-U/mL ( 10 : Negative, 10-20 LOW POSITIVE 20-40 MODERATE POSITIVE) CARDIOLIPIN ANTIBODY – lgA 13.27 PL-lgA-U/mL ( 10 : Negative 10-20 LOW POSITIVE) PROLACTIN (PRL) 11.67 ng/ml (Result) (Normal Range ; Females Non-Pregnant: 2.8 – 29.2) Thyroid Stimulating Hormone ( TSH ) 1.06 ulU/mL (Result) (Normal Range 0.34-5.60 ulU/mL) FSH 6.17 mIU/mL (Result) (Normal Range (Normal Range Femal Follicular phase 2.5-10.2) Date : 28 September 2010 After 2 months medication repeated below tests Lupus Anticoagulant 1 (Screen) 32 sec (Normal 28-45) Lupus Anticoagulant 2 (confirm) 36 sec (Normal 28-40) Ratio (LA1/LA2) 0.88 ( 1.3 Normal) A.P.T.T TEST 27 sec (result) (Normal 30-40 sec) CONTROL 24 sec (result) (Normal 30-40 sec) ANTI CORDIOLIPIN ANTIBODIES CARDIOLIPIN ANTIBODY – lgM 8.71 PL-lgM-U/mL ( 10 : Negative) CARDIOLIPIN ANTIBODY – lgG 10.9 PL-lgG-U/mL ( 10 : Negative, 10-20 LOW POSITIVE ) CARDIOLIPIN ANTIBODY – lgA 7.26 PL-lgA-U/mL ( 10 : Negative) Date : 10 January 2011 Found that my sister is affected with TB undergone 6 months course for TB Date : 17 May 2011 Suggested Laproscopic surgery for better findings, after laproscopic surgery below is the discharge summary Recurrent Pregnancy loss for evaluation Operative Hysteroscopy & Laparoscopy done on 17 May 2011 At Hysteroscopy: • Both ostia visualized normally placed • Uterine cavity normal At Laparoscopy: • Uterus normal size • Both tubes normal. Dye test positive both sides. • Small fimbrial cyst present on test tube, excised. • Both overies polycystic, ovarian drilling done • POD free, No E/O adhesions or endometriosis Biopsy result Nature of Specimen: Endometrial Curettings for HPE Microscopic Examination: Sections revealed endometrial tissue with predominantly blood clots and few glands in proliferative pattern. No evidence of neoplasia or granulomas Impression: Proliferative pattern What I want to say: After three miscarriages my sister undergone above tests and some test results were not in normal range, after two months medication those readings came to normal range. And upon our request for any tests Dr. went for Laproscopic surgery and said that she has done ovarian drilling and uterus condition is good and biopsy says that TB which attacked my sister doesn’t have any effect on her uterus. And Dr also says that we need to go Ecosprin and Loprin (not sure of the correct names) injections continously till 9th month once after conceived What I want to ask: There was no specifc finding from Dr that this was the reason for 3 repeated miscarriages, to the best of my knowledge except karotyping we have completed all tests. I am seeking your suggestion in case we are missing any other tests and will be there any side affects of taking daily injections for 9months and any other suggestions/advice are invited. Our whole intension is not to have another miscarriage. Thanks in Advance