Q. Why am I having frequent miscarriages?

Answered by
Dr. Uzma Arqam
and medically reviewed by iCliniq medical review team.
Published on Feb 02, 2019

Hello doctor,

I have had four miscarriages in a row. One had a subchronic hematoma. Is there a reason for this or a way to stop? I have given live births but now I cannot keep a child. What can I do?

Dr. Uzma Arqam

Obstetrics And Gynaecology
#

Hi,

Welcome to icliniq.com.

Recurrent miscarriages need to be investigated actually. You had live births but now had four consecutive miscarriages. It is better to have a thrombophilia screen and products of conception needed to be send out for histopathology to check any chromosomal, congenital, structural anomaly. If you have been treated for any health issues like diabetes, thyroid, or high blood pressure, better have a complete, revised and regular treatment. All levels of blood pressure, thyroid, sugar levels should be within normal range as high sugar levels, high blood pressure, abnormal thyroid function test can trigger miscarriage. Have Folic acid continuously 5 mg as the abnormal product of conception, with structural, congenital or chromosomal anomalies can be aborted easily by nature itself.

A hormonal imbalance like polycystic ovaries need hormonal support like Duphaston and Metformin during pregnancy for maintenance. Have a healthy diet, less salt, sugar, oil, and spice. Try to have normal BMI and weight as both high and low BMI can affect conception. Husbands health issues also need to be sorted out. Have recreational activities and quit recreational drugs as a couple as these reduces fertility in both gender and can cause fetal anomalies. You need blood thinning medications as well as soon as fetal viability comes like Aspirin, Heparin, etc. It is better to have an early booking with maternal medicine and high risk pregnancy consultant obstetrician. Send me your recent blood reports, detailed medical, gynecological, obstetrics and drug history and have thrombophilia screen, rubella screen. So that you could be guided more nicely.


The Probable causes:

Medical issues to be sorted out, if any.

Investigations to be done:

Thrombophilia screen, rubella screening.

Probable diagnosis:

Recurrent miscarriages.

Treatment plan:

Folic acid daily 5 mg, sex in the fertile period of the cycle, early booking with high risk and maternal medicine consultant obstetrician. Blood-thinning medications as soon as fetal viability confirms. Progesterone support as soon as pregnancy test comes positive or cycle miss.

Preventive measures:

Complete check and regular treatment and care of any health issue she has, healthy lifestyle, have normal BMI and weight, daily walk and exercise. Quit recreational drugs as a couple. Husband's medical issues also needed to be sorted out.

Thank you doctor,

I have just sent you the files that I have. I saw a hematologist about my Iron. I did not absorb iron well so it is low and he told me I am having a clotting problem but cannot check because my blood count is low. When should I take the baby Aspirin to help with the clotting? They also gave my vaginal Progesterone the last time I was pregnant. How long should I take the baby Aspirin too? Please let me know what you see from my results.

Dr. Uzma Arqam

Obstetrics And Gynaecology
#

Hi,

Welcome back to icliniq.com.

I have seen your reports (attachment removed to protect patient identity) and came to know about anemia you have that need to be corrected as urgent before trying for conception.

For pregnancy, you need to have normal hemoglobin at least 11.5 mg/dL. Start Iron supplement from now and have a detailed consultation with consultant physician regarding this anemia properly. You need to check symptoms as well like faintness, weakness, tired feeling all the time, low blood pressure, etc., as anemia could give you these symptoms and could be a difficulty to proceed with the pregnancy. Better discussing this blood issue in detail will be helpful, you might need Iron infusion or blood transfusion if symptoms intensify. Have carrot and apple juice, spinach and food full of Iron. Progesterone is helping to maintain pregnancy, if some hormonal issues with a female it is advised to give as oral, as a suppository, etc., even till advanced pregnancy third trimester. So you can continue and have the first scan to show fetus (tablet Duphaston 1-0-1). Aspirin also to be started as soon as fetal heart sounds are confirmed on the scan.

As I advised you about early booking under consultant obstetrician, maternal medicine, and high-risk pregnancy. So, better to discuss injectable heparin with them, even they shall prefer that as well. So, now correction of anemia and consultation for this is a top and urgent priority for you.


The Probable causes:

Coagulation disorder, anemia.

Investigations to be done:

Hemophilia screen, rubella screen.

Preventive measures:

Iron supplements. Food full of iron, apple, carrot juice, spinach, etc. Immediate consultation with consultant physician or hematologist for correction of anemia to 11.5 mg/dL. Have complete check-up, detailed regular follow-ups for whole body general well-being.

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