PREGNANCY-BIRTH Messages for April, 2001: Re: 2ND MISCARRIAGE-PREVENTING A 3RD?

Re: 2ND MISCARRIAGE-PREVENTING A 3RD?

From: M. Kelly Shanahan, MD, (anonymous@obgyn.net)
Fri, 27 Apr 2001 14:51:35 -0500 (CDT)

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In reply to: SANDY: "2ND MISCARRIAGE-PREVENTING A 3RD?"

At Fri, 27 Apr 2001, SANDY wrote: >
>MY FIRST MISCARRIAGE ENDED AT ALMOST 14 WEEKS WITH A D&C (DECEMBER)-NO
>FETAL HEARTBEAT. WAS TOLD TO WAIT UNTIL I HAD "3" REGULAR MENSTRUAL
>CYCLES BEFORE TRYING AGAIN. EVERYTHING WAS PROGRESSING WELL-AFTER "3"
>REGULAR MONTHS STARTED TRYING AND FOUND I WAS PREGNANT ON APRIL 18TH AND
>WAS 5 1/2 WEEKS PREGNANT- I STARTED TO EXP. SOME CRAMPING/BLEEDING
>SEVERAL DAYS LATER. I HAD TAKEN "3" HPT ALL POSITIVE-DR'S URINE TEST
>SHOWED NEGATIVE. HOWEVER, BLOOD TEST CAME BACK POSITIVE-HCG OF 29. WAS
>TOLD THAT I EXPERIENCED AN EARLY MISCARRIAGE AND WOULD REQUIRE MORE
>BLOOD WORK FOR HCG MONITORING-AND HOPEFULLY WILL NOT REQUIRE ANOTHER
>D&C.

or you could be very early pregnant and your levels will continue to rise.

I HAVE NO EXPLANTIONS FOR EITHER LOSS-AND DR'S DO NOT PROVIDE >FURTHER TESTING UNTIL "3" CONSECUTIVE MISCARRIAGES.

your doctor needs to readd the most recetn ACOG bulletin on this Subject: ACOG Procatice Bulletin #24, Feb 2001, entitled "Management of Recurrent Early Pregnancy Loss". this states that "..patients with two or more consecutive spontaneous abortions are candidates for an evaluation...."

if your doctor will not do the evaluation (which is detailed in this proctice bulletin), then you should see a reproductive endocrinologist or a general gyn who is well versed in repeated miscarriage

MY QUESTION IS TWO >FOLD: HOW LONG SHOULD WE WAIT BEFORE ATTEMPTING ANOTHER PREGNANCY
>(PHYSICALLY)

once you start cycling normally and are emotionally ready to try again

AND ARE THERE ANY SPECIFIC TESTS I SHOULD REQUEST BEFORE WE >TRY AGAIN?

the work up includes anticardiolipin antibodies and lupus anticoagulant;luteal phase defect (evidence here not quite as strong); chromosomes of you and your partner; evalutiaon of the uterine cavity by HSG or saline infusion ultrasound

I FEEL LOST AND DONT KNOW HOW AGGRESSIVE I NEED TO BE WITH >DR'S FOR FURTHER INFO/TESTING-AFTERALL I UNDERSTAND THAT THE CHANCES FOR
>A MISCARRIAGE ARE 20%,

it's actually 30% after 2 consecutive

PERHAPS I WAS JUST UNFORTUNATE THE FIRST TWO >TIMES-HOWEVER I'M VERY ANXIOUS AND CONCERNED THAT THIS IS SOMETHING MORE
>AND I DON'T WISH TO EXP. A THIRD MISCARRIAGE IN ORDER TO MEET
>QUALIFICATIONS FOR FURTHER TESTING-I'M TOLD THIS IS STANDARD PRACTICE.

not any more it's not

>ANY SUGGESTIONS?

seek a second opinion -- and good luck.

-- M. Kelly Shanahan, MD, FACOG South Lake Tahoe, CA

author, Your Over-35 Week-by-Week Pregnancy Guide available in all major bookstores and on-line at amazon.com http://www.amazon.com/exec/obidos/ASIN/0761526986/o/qid˜6597740/sr=8-1/ref=aps_sr_b_1_1/103-7407404-7691069http://www.amazon.com/exec/obidos/ASIN/0761526986/o/qid˜6597740

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