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Re: ccurent miscarriagies-I ask for any advise for the following case.From: DR. VERONICA MALLARI-DENIEGA (bobcacmd@mozcom.com)Sun Mar 17 10:50:09 2002
At Sun, 17 Mar 2002, art fougner, md wrote: > >Occasionally voodoo and witchcraft fail too. wish i could be more >helpful. > >art > >At Sun, 17 Mar 2002, y.n. wrote: >> >>My patient is 38 years old today. >>Her husband has azospermia due to hypogonadotrophic hypogonadism. >>In the past, he was tried with gonathotropins (Puregon+Pregnyl) but soon >>he got tired with injections and he stopped them. >>Both they decided to use husband’s brother sperm who has two healthy >>children. >>About 3 years ago, we started with IUI during physical cycle. Her cycle >>is always normal lasting 28-30 days. >>1st pregnancy >>missed abortion (anembryonic untill 8th week) àD&C >>-no TORCH infection was found. >>2d pregnancy >>missed abortion (anembryonic untill 8th week) àD&C >>-abortuses failed to be cultured for karyotyping. >>3d pregnancy >>missed abortion (embryonic stuck were seen. Heart activity stopped in >>8th week) àD&C >>-abortuses revealed normal 46XX karyotype. >>Testing for ANA, LLA and ACA was negative. >>Wife’s karyotype was normal. >>Another donor sperm was insisted, but they denied. >>4th pregnancy >>biochemical pregnancy. b-HCG rised slowly up to 600IU and then felt to >>negative >>àno D&C. >>5th pregnancy >>Everything get well untill 15th week. >>She was examined by ultrasound every week. Red bleeding was seen from >>vagina on 7th week and a large hematoma was seen in utero that absorbed >>during the following 20 days. Progesterone (Utrogestan 100mg three >>times daily) and low dose Aspirin (Salospir-A 80mg/day) per os was >>administered. >>Glucose intolerance was abnormal, slight up normal limits. Postpardial >>glucose was not above 125mg/dl after diet started. >>Nuchal translucency was normal on 12th week. >>Next visit on 14th week, it was thought that amniotic fluid was little >>less than expected. >>Next visit on 16th week, fetus has no heart activity and amniotic fluid >>was absent. No fluid coming through the vagina was seen during the >>previous days. >>Pregancy was discontinued. Pathologic examination of fetus and placenta >>is expecting. >> >>I look for any medical advise. >>I don’t believe that immunotherapy using 3d party lymphocytes or IV >>immunoglobulin has any positive role in these cases. >>What would you do in my case? > >-- >art fougner, md >ich bin ein New Yorker >Try looking up on APAS (antiphospholipid antibody syndrome). I had a patient with 2 miscarriages and she had this syndrome after a full work-up. It affects everything from the placenta to embryo.
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