Hello doctor,
My 29-year-old sister has a 5-year-old son. It was premature delivery (34th week) and it was a normal delivery. After that, for three times she had abortions and all were between 8 to 10 weeks because of no fetal growth and no heartbeats found. Currently, she is 10 weeks pregnant. Recently, an ultrasound scan was done and the report was good with heartbeats found.
In the investigation report, we came to know that her vitamin D level is 12 and the B12 level is 227. Will the low vitamin levels have an impact on the baby? Should she continue the pregnancy? Fetal hemoglobin (HbF) is 0.9 %, Hemoglobin A0 (Hb A0) is 96.5 %. Hemoglobin A2 (HbA2) values before last year were between 94.3 and 98.5. Please give your opinion.
Hello,
Welcome to icliniq.com.
The vitamin D levels are in a deficient range and vitamin B12 levels are normal. There is no need to discontinue the pregnancy due to these values.
Vitamin D supplementation will help to gain adequate levels in the baby.
I suggest you start with vitamin D supplementation of Calcirol sachet 60000 IU weekly after the 12th week of pregnancy for eight weeks.I hope your sister is already taking folic acid 5 mg daily.
I also hope she has already undergone routine investigations of pregnancy like
- Hemoglobin,
- Urine routine examination,
- TSH (thyroid-stimulating hormone),
- FBS (fasting blood sugar),
- Neonatal hemoglobin electrophoresis,
- VDRL (Venereal Disease Research Laboratory) test,
- HIV (human immunodeficiency virus),
- HBsAg (surface antigen of the hepatitis B).
Also hoping the NT (nuchal translucency) and NB (nasal bone) are normal. Please review if otherwise.In view of previous three abortions, I suggest she start tablet Ecosprin (Atorvastatin and Aspirin) 75 mg daily and continue for 36 weeks.
Also get tests for APLA (antiphospholipid antibodies), LAC (Lupus anticoagulant) and aCL (anticardiolipin). According to the report, we will decide whether further pregnancy support is required or not.
I suggest she does not take any medications except folic acid, Ecosprin (Atorvastatin and Aspirin) and Doxinate (Doxylamine and Vitamin B6 (Pyridoxine)) for vomiting for the first three months (12 weeks) of pregnancy to avoid congenital malformations in the baby. Consult your specialist doctor, discuss with him or her and with their consent take the above medicines.
For more information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist
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