NIApedia

A: Without more information, it impossible for me to give you very specific advice, but I will do my best to address your concerns. From your letter it sounds as if you may have had two first-trimester miscarriages (within the first 12 weeks of pregnancy) and one ectopic (a pregnancy in a fallopian tube).

The good news is that since you have been pregnant three times before, it seems that you are able to get pregnant fairly easily. Therefore, I would say that your chances of having a child are quite good.

The first step I would recommend is to visit your OB-GYN and request testing for repeat pregnancy loss (RPL). This is defined as having at least three spontaneous miscarriages. Technically, you have only had two spontaneous miscarriages (since the third pregnancy was an ectopic), but in my practice, I usually recommend doing a thorough workup after the first two miscarriages.

Most early miscarriages can be blamed on a fetal chromosomal problem. Perhaps there was a little extra genetic material or not quite enough genetic material in the fetal cells. This is Mother Nature's way taking care of a pregnancy that is not normal.

Another very common reason for early miscarriage is that the woman's progesterone levels are too low. The hormone progesterone needs to be at a certain level in order for a pregnancy to survive. If your doctor suspects this problem, she or he may want to give you progesterone supplements.

A much less common reason for miscarriage is the presence of certain antibodies in your system that are interfering with the ability of the placenta to develop normally. The placenta is crucial because it provides a developing fetus with the nutrients and oxygen necessary for growth and development.

If testing reveals that you are a carrier of these antibodies, you may be treated with low-dose aspirin and an injectable medication to keep your blood from clotting in the vessels of the placenta. You doctor may also consider treatment with steroids.

I would also suggest that you have your thyroid-hormone levels checked. Too much or too little thyroid hormone can interfere with conception and early pregnancy.

Finally, once you do conceive, it is extremely important that you get to your OB-GYN immediately--the minute you find out you are pregnant. Resolve: The National Infertility Association can provide support and more information.

Andrea N. Price, M.D., is a board-certified OB-GYN specializing in general obstetrics and gynecology; she practices in Shrewsbury, New Jersey. Visit her Web site at WomenofColorOBGYN.com

Published on: 05/20/2002


Do You Have a Health Question?

If you have a health question or concern about this or any other topic, ask us in the comments section at the end of the article or send email to lvillarosa@niaonline.com. Our health expert will address your question as thoroughly as possible.

Please use this Q&A section to broaden your knowledge, but do not use it as a substitute for consistent, personal medical care from a qualified professional.






Type in the email address