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Re: Testing for recurrent miscarriageFrom: Marcia (anonymous@obgyn.net)Tue, 30 Jun 1998 09:03:50 -0500 (CDT)
In addition to what the doctors have said, you might want to check out this web site: http://www.pinelandpress.com/support/rpl.html It helped me a lot when I was in your situation! Good luck!At Sun, 28 Jun 1998, anonymous@obgyn.net wrote: > >At Sun, 28 Jun 1998, laura wrote: >> >>I am currently experiencing my 3rd miscarriage. I have had no >>successful pregancies so far. > >First, I am very sorry that you have had a miscarriage. Although >miscarriages are extremely common (some say about 1/2 of all pregnancies >end as a miscarriage), they are very emotionally painful. As you >suggest, there are a number of tests that your doctor can offer you to >determine if you have a condition that leads to recurrent miscarriage. >Of course, without knowing your full medical (and family) history, and >performing a physical exam, the information below should be considered >as educational. Your situation may vary slightly. > >Antiphospholipids- These are antibodies that circulate in the blood >stream and attack the placenta. They are also associated with blood >clots, fetal growth restriction, and hypertension. Anticardiolipin >antibodies and lupus anticoagulant are two of the most common tests in >this category. Treatments usually consists of a baby aspirin once a day >to block the antibodies, and sometimes a "blood thinner" called heparin >given as an injection under the skin 1-3 times a day. > >ANA- This is a test for the antinuclear antibody. This is associated >with a condition called lupus, but many women without lupus still have >this antibody. Baby aspirin is the usual treatment. > >Maternal and paternal chromosomes- A blood test of the mother and father >is taken to determine if there are any hidden chromosomal (genetic) >defects that could be passed on to the baby. This is expensive >(sometimes $1000 per person). > >Hysterosalpingogram (HSG) or sonohysterography- These tests evaluate the >inside of the uterus to determine if there is any scar tissue or >congenital anomalies. If found, outpatient surgery can often correct >the problem. > >Testing for infection- Cervical cultures can help locate infection. This >is controversial, as the role of bacteria and miscarriage is not proven. >Some doctors just give antibiotics "just in case", since they are >generally cheap, easily tolerated, and safe. > >Luteal phase defect- Another controversial diagnosis. Here, the lining >of the uterus may be "out of phase" and slough off too early, leading to >miscarriage. As you have had a 14 week miscarriage, this diagnosis is >unlikely. It is hard to diagnose, and usually requires 2-3 endometrial >biopsies, done in your doctor's office. Some doctors skip the biopsies >and simply prescribe progesterone suppositories. These are considered >safe, but you should know that they have not consistently been proven to >help prevent miscarriage. > >Incompetent cervix- Unlikely given your history. In this situation, the >cervix is weak and opens too early. This is more common in miscarriages >that occur later than yours, say in the 20 week range. An internal exam >before and during pregnancy, and sometimes serial vaginal ultrasounds, >can help make the diagnosis. > >As you can see, there are a number of conditions that can cause >recurrent miscarriages. You and your doctor need to work together >closely to try to find out why you have had 3 miscarriages, particularly >one at 14 weeks. Please talk about your concerns with your doctor. If >he or she is unable or unwilling to pursue this, you may wish to get a >2nd opinion. > >My best wishes to you. Please know that I have delivered many babies of >women who have very similar stories to yours. > >-- >Ashley Hill >David Ashley Hill, M.D. >Associate Director >Department of Obstetrics and Gynecology >Florida Hospital Family Practice Residency >Orlando, Florida > >The above information is provided for medical education only, and is not >intended as specific medical advice. I am sorry, but due to time constraints, >I am unable to answer personal e-mail. >
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