Q. My wife was given different opinions from two doctors. What shall we do?

Answered by
Dr. Neha Singh Rathod
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Oct 27, 2016 and last reviewed on: Oct 07, 2020

Hi doctor,

My wife, who is 23 years old, has autoantibodies SSA strong positive 3+, SSB borderline positive and RO52 strong positive 3+. She lost her first pregnancy last year, because CHB was found on fetus by TIFFA at 19 weeks with fetal hydrops bradycardia. Now, she is 8 weeks pregnant. Our obstetrician planned the treatment as Aspirin 75 mg once daily, Enoxaparin 20 mg daily, Progesterone 200 mg tablet once daily and Dailyfol. She also planned to start fluorinated steroids from 12th week and immunoglobulin from 16th week. When we went for a second opinion two days back, fetal medicine specialist found large subchorionic hemorrhage and advised just to stop Enoxaparin. She advised us to come back again after a month as it is a high risk pregnancy. Why did she say so? Later, we consulted our obstetrician and she also advised to stop Enoxaparin temporarily because it is necessary for controlling antibodies. She advised Duphaston 10 mg twice daily, Xamic 500 mg twice daily in addition to the above and asked us to have a review after three days. We need a clear direction now. Can we prevent CHB with the above medication? Is really there a need for Enoxaparin? Who is the right person to follow? Should she get steroids for prevention of CHB? She has morning sickness and back pain from the beginning of pregnancy.

#

Hi,

Welcome to icliniq.com.

  • These medications are given to your wife for fetal well being and these medications are definitely going to help.
  • Since there is a subchorionic hemorrhage, you have been advised to stop Enoxaparin. She may go a little easy with this medicine and restart it as per advised.
  • Both the doctors have given you the same advice, but in a different way. The method of treatment of each doctor may vary, but the mode of treatment will definitely be the same. So, you can follow any advice as both of them mean the same in a different way though.
  • Regarding her morning sickness and dullness, it is very common in pregnancy and you really need not worry about that. It will resolve as and how the pregnancy progresses.
  • Ask her to start with her calcium supplements as she is complaining of back pain. Please do not worry. Things will be taken care of. The only thing is to be a little careful and get your routine antenatal visits done.

For further information consult a fetal medicine specialist online --> https://www.icliniq.com/ask-a-doctor-online/fetal-medicine-specialist

Thank you doctor,

Actually, last time, till the third month my wife was very well. But, in the third month, she used to faint when she stands for a minimum of 10 minutes. But, her gynecologist said there is nothing to worry. Then by the fourth month, as the doctor could not hear fetus heartbeat easily she advised for TIFFA scan.

This time, I have consulted a doctor at icliniq.com already and consulting with a gynecologist now whom they recommended in my area. After the termination of pregnancy, my wife was on regular Aspirin 50 mg and Folinol. Actually, I am worrying more this time and so, in need of a second opinion always. Our gynecologist said Xamic 500 is to control bleeding. She also said actually at present there is no bleeding and it happened once internally. If so, then why did she prescribe Xamic? Also, the fetal medicine specialist did not prescribe anything. Why?

#

Hi,

Welcome back to icliniq.com.

I really understand your concern and worry. With all due respect to that, I would like to tell you that please relax. I am not telling you not to take care, but I am asking you to go a little easier.

  • During the fourth month, it is difficult to find out the baby heartbeat with a stethoscope and that must be the reason that she took so long to find out baby heart beat.
  • The fetal medicine doctor will not prescribe you any medications and she would give only counseling.
  • You are in safe hands, please do not worry. Get your routine check up done and things will be definitely fine.

For further information consult a fetal medicine specialist online --> https://www.icliniq.com/ask-a-doctor-online/fetal-medicine-specialist


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