Repeated Miscarriage

Repeated Miscarriage, Hypothyroid, Amniocentesis

Patient presented to us after first Miscarriage (No heart beat found)

While she was under our care, 2nd pregnancy also ended up in miscarriage

Before further investigations could be taken, she conceived for the 3rd time

After long discussion about merits and demerits, she opted for “EMPIRICAL THERAPY” (medicines with unproven benefits)

After confirmation of heart beat, Empirical therapy* was started

L-Thyroxine was supplemented for subclinical hypothyroidism

Quad Test showed high risk of Down Syndrome, for which AMNIOCENTESIS was advised and the result came as NORMAL

Serial Growth Scans detected FETAL GROWTH RESTRICTION (Inadequate Growth of the baby)Baby was in BREECH (upside down)

Steroid injection was given for lung-maturity of the baby

Healthy Male baby born by C-section at 36 weeks

Success after 5 Miscarriage, Bicornuate Uterus

35 years old lady with INFERTILITY and 5 REPEATED MISCARRIAGES (3 at 12 weeks, 2 at 18 weeks).

Bicornuate uterus was seen in ultrasound and confirmed by hysteroscopy-laparoscopy.

She was offered operative correction, which she refused.

After explaining risks, she opted for ovulation induction.

After 2nd cycle, she conceived but surprisingly it was TRIPLET (2 in left horn, 1 in right horn).

At 26 weeks, she developed preterm labour and 2 babies were delivered vaginally.

Surprisingly, the 3rd baby in Right horn continued till 35 weeks, when emergency C-section was done because of she had ruptured membranes (PROM).

The 3rd baby was healthy and went home smoothly.

Pic taken during C-section with her kind permission.

Repeated Miscarriage, Thalassaemia Carrier

Mother having history of 2 REPEATED MISCARRIAGES, both at 8 weeks

NO CAUSE was identified for the REPEATED MISCARRIAGE

After explanation, she opted for NO EMPIRICAL THERAPY (that means, she refused trying some medicines, which are commonly used to ‘prevent’ miscarriage, but effectiveness is questionable)

She is a known THALASSAEMIA CARRIER with Anaemia

Throughout pregnancy her haemoglobin was carefully monitored and was kept 9.5 g/dl before delivery

She delivered healthy baby at 38 weeks

Though she was at risk of bleeding during delivery, she did NOT require BLOOD TRANSFUSION

Unexplained Repeated Miscarriage, Infertility

REPEATED MISCARRIAGE at 1st Trimester, followed by SECONDARY INFERTILITY (Inability to conceive)

Despite thorough Investigations, NO CAUSE was identified for INFERTILITY and REPEATED MISCARRIAGES

Conceived naturally with their patience, faith and perseverance in DIFFICULT TIMES

NO ADDITIONAL MEDICINE was used, except those used in normal pregnancy

Only ‘treatment’ provided was TENDER LOVING CARE (Counselling, Support and Emotional Boosting when one feels FRUSTRATED)

Pregnancy was complicated by off and on bleeding but everything was fine eventuallyNormal Vaginal Delivery of a healthy male baby at term

Empirical Treatment, Repeated Miscarriage, Old Age

39 years old lady came with 2 REPEATED MISCARRIAGES (No heart beat of the baby was detected)

NO CAUSE was identified for the REPEATED MISCARRIAGE

After explanation of limited role of treatment options, she opted for EMPIRICAL THERAPY (that means, she agreed to try some medicines, which are commonly used to ‘prevent’ miscarriage, but effectiveness is questionable)

This included progesterone, aspirin and low molecular weight heparin injectionUnfortunately she miscarried 3rd time under our care (initially heart beat was seen but lost subsequently)

She kept TRUST on us and conceived 4th time!!!

This time pregnancy continued till term and she delivered a healthy baby

Unexplained Repeated Miscarriage, Infertility, Obesity,

•Infertility with Recurrent Miscarriage
Patient presented to us with previous 2 early miscarriage (no heart beat seen) followed by secondary Infertility.
All investigations were normal (hormones, ultrasound, tubes, semen). Regarding Miscarriage- karyotype, Anti Phospho lipid antibody, 3D ultrasound all were normal.
She was obese with hypothyroid.
As a treatment of “UNEXPLAINED INFERTILITY” she received several cycles.
The Recurrent Miscarriage was also UNEXPLAINED.
We discussed with her next treatment plan. She tried to wait and fortunately conceived within 3 months SPONTANEOUSLY.
Regarding UNEXPLAINED REPEATED MISCARRIAGE, we discussed with her treatment options and their limitations and lack of GUARUNTEE that these treatment are 100% effective. She opted for these treatment as a last resort. We repeatedly explained that all these treatment may fail and without medicine successful outcome can happen.
1. Hydroxyprogesterone caproate inj (500) twice weekly till 20 weeks
2. Natural micronized progesterone gel once daily till 30 weeks
3. Inj hCG (5000) twice weekly till 12 weeks
4. Inj Enoxaparin (40) daily till delivery
5. Inj IgG once in 3 weeks till 18 weeks
6. Tab dydrogesterone 20 mg/day till 20 weeks
7. Aspirin 75 mg/day till one week before delivery.
We planned for delivery at 37 weeks. But suddenly she went into labour and the liquor was MECONIUM STAINED (baby passed stool and was distressed before delivery). So decision for Emergency C Section was taken.
She delivered a healthy Male Baby last night.
A mother’s smile with her baby in her lap is just DIVINE.