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Monday, May 20, 2013
Seeking advice for 2 spontaneous abortions
My wife is p0+2 1st was spontaneous abortion at 10 wk,2nd was anovular gestation.Karyotyping of both product of conception was 46xx.Karyotype of both partner are normal. Her CBC,SUGER,urea,creatinine,LFT,TSH,DAY2 LH FSH PROLACTINE,are normal.Anti cardiolipine antibody and Lupas anti coagulant not detected.What should be the next line of management?
Other tests may include factor V Leiden, protein C and S activity, prothrombin gene mutation, as well as homocyteine levels. I would suggest that you ask your doctor about these tests which determine if you have a predisposition to clotting that may increase your risk of pregnancy loss.
Finally, a uterine cavity evaluation should be done (either a saline infusion sonography or an HSG).
If all testing were normal, I usually recommend a baby aspirin plus natural progesterone.
Daniel B Williams, MD
College of Medicine
University of Cincinnati