Hi doctor,
I had three miscarriages after taking a Progesterone injection. The two miscarriages were chemical pregnancy and the other one was formed. But miscarriage happened. Now I am having pregnancy symptoms. My last menstrual period was 40 days back.
Hi,
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Based on your obstetric history, it is necessary to evaluate the cause of having a recurrent miscarriage. Progesterone injection will not cause any miscarriage as progesterone is the hormone necessary for the continuation of pregnancy and it acts as a support for pregnancy. The common causes of recurrent miscarriage are thyroid abnormalities or impaired blood glucose level or sometimes immune causes like APLA (antiphospholipid antibodies) syndrome. According to your LMP (last menstrual period), you are exactly six weeks pregnant, and do a scan to check whether it is a viable pregnancy. If it is viable, you can start taking Progesterone in the form of oral supplements to sustain pregnancy. You need to undergo some blood tests to look for any abnormalities other than antenatal investigations.
You need to do blood group and Rh (rhesus) typing, complete hemogram, Hb (hemoglobin) electrophoresis, urine routine and microscopy, LFT (liver function test), RFT (renal function test), 75-gram oral glucose tolerance test, Hba1c (hemoglobin a1c), HIV (human immunodeficiency virus), VDRL (venereal disease research laboratory test), HbsAg (hepatitis B surface antigen), anti-HCV (anti-hepatitis virus C) and APLA (antiphospholipid antibodies) workup. It includes lupus anticoagulant, beta 2 glycoprotein IgG (immunoglobulin G) and IgM (immunoglobulin M), and anti-cardiolipin antibodies IgG and IgM. You need to do an NT (nuchal translucency) scan (11 to 13 weeks), dual marker test (11 to 13 weeks), and level 2 scan (18 to 20 weeks) to look for any structural or developmental abnormalities in the fetus.
Treatment plan:Take Progesterone supplements after checking viability and low dose aspirin or heparin can be taken after doing an ultrasound for viability and blood test evaluation.
Preventive measures:Avoid having intercourse in the first trimester and take small meals at frequent intervals to avoid having nausea or bloating.
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