Q. Two consecutive miscarriages have greatly disappointed the family. What to do next?

Answered by
Dr. Gowrimeena
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 29, 2017

Hello doctor,

I am writing for my daughter, staying away from us, with her husband. She is 30 years, 5 feet 1 inch and 63 kg, working in the IT sector. She is married for the last three years and seriously trying for conception from a year. She missed her period once in the beginning of this year. During her obstetrics consultation, beta hCG was done. It was repeated after two days. A transvaginal ultrasound scan was done and repeated after 10 days. The end result was diagnosed as a blighted ovum. So, it was evacuated by D and C.

Our daughter is of normal build and nutrition. Her menstrual history was normal since the beginning in terms of cycle, duration, and flow. But, one month after D and C, she did not have her period. On the doctor’s advice, she took some medicines and bleeding occurred. She was known hypothyroid. So, she was taking Thyroxin 50 or 75 to keep the TSH near about 2.5 Uiu/ml. Her Hb % and sugar are within the normal range.

Again, she tried to conceive since three months ago along with Aspirin and folic acid. She missed her period last month. Her beta hCG was 9.20 mIu/ mL. It was repeated after two days. It came down to 1 Miu/ml suggestive of 'chemical pregnancy'. This time, after a few days, a spontaneous jelly-like bleeding occurred for two days. I would like to add that her husband requires to take Penegra 50 mg tab before a performance. Our daughter is immunized with triple antigen, polio, MMR, chickenpox and hepatitis B vaccine in childhood. The transvaginal scan (done at a later phase of the first conception) showed normal anatomical and physiological pattern of the ovary and uterus to me at least (report attached).Two consecutive miscarriages brought great disappointment to all. Presently, the doctor told her to take Aspirin 150 mg, folic acid, and Vitamin B12 combination tablet and to try for pregnancy again. I want your valuable opinion regarding subsequent management or the right line of treatment and suggestions or tests (if any) to get a successful pregnancy and healthy baby.

Dr. Gowrimeena

Obstetrics And Gynaecology


Welcome to icliniq.com.

I have gone through your daughter's reports (attachment removed to protect patient identity).

  • From the detailed information that you have given, the first pregnancy was a blighted ovum (miscarriage). The second pregnancy is a chemical pregnancy and not a true miscarriage. This is best considered as a single miscarriage only.
  • Since your daughter's tests are within the normal limits, the next pregnancy should be fine.
  • Folic acid is important, apart from continuing Thyroxine.
  • Low dose Aspirin can also be started as soon as the fetal heart is visualized on the scan.
  • I would like to know her rubella IgG status, that is, immunity status. Even though this is not directly related to miscarriage, it is part of the prepregnancy workup. I would like to know the results of histopathology of POC (products of conception) of first pregnancy, if available.

Hope this helps. Regards.

For more information consult an obstetrician and gynaecologist online --> https://icliniq.com./ask-a-doctor-online/obstetrician-and-gynaecologist

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Thank you doctor,

Regarding rubella IgG, she was tested during the early phase of the first conception. The result was suggestive of a previous rubella infection or was immunized. I wrote to you that she was given MMR vaccine in childhood. The histopathology exam of products of conception was not advised after D and C. So, I do not have the report. She already started folic acid and vitamin B12 combination, Aspirin 150 mg and Eltroxin 50. My question is, can she try for a pregnancy immediately or after a gap?

Dr. Gowrimeena

Obstetrics And Gynaecology


Welcome back to icliniq.com.

  • Two months gap is advisable for physical and emotional recovery.

Hope this helps.

For more information consult an obstetrician and gynaecologist online --> https://icliniq.com./ask-a-doctor-online/obstetrician-and-gynaecologist

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