Question: My wife recently had a 3rd failed pregnancy (miscarriage) in the first
trimester (1st: miscarriage; 2nd: IUGR case). Doc this time had put her on Aspirin
as part of the antenatal care meds. Scan stated cause of incomplete abortion to be
“blighted ovum”. The specimen from the Uterus during D&C was sent to the lab, the
report of which read: “Histology shows inflamed necrotic decidua” .
In an effort to determine the cause the Doc ordered blood test on 30/08/10 for viral infection. The lab report of 30/8/10 read:- (Results supplied)
Doc has prescribed meds for Herpes (Herperax) to be taken by both of us for 3 Months and to be protective for 3 months. Now an infectious disease specialist says that these tests indicate there is presence of the Herpes and CMV virus and according to his interpretation of these results, my wife did not catch the viral infection during pregnancy which might have caused the miscarriage; the virus may have been picked up long before she even first conceived – perhaps in childhood. He further said that these results only tell us of the existence of the virus in the body and there is no way the virus can be eliminated from the system. The virus can become active and there are symptoms like rashes (as in shingles), soreness in lips, blisters in genital area, etc. According to this Infectious Disease Doc, the treatment that the Obs/Gyn has prescribed is of no use and it is only useful in the treatment of the symptoms of the infection – if the virus became active he would prescribe the medicine and that for about 5 days. This medicine will therefore not eliminate the virus, and even after 3 months of taking the medicines the lab result will still be similar. So, as far as the viral infections go we should not be taking the meds. The Obs/Gyn has asked us to visit him after 3 months when he will repeat the Herpes tests and then consider other tests like genetic testing. I would like to know 1) whether to follow the Obs/Gyn or the Infectious Disease specialist and 2) whether these tests are conclusive as to the cause of these failed pregnancies based. Many Thanks
Answer: I am afraid your wife’s Obstetrician has misled you. From the results you have given here, the infectious diseases specialist is spot on with everything he/she has said. The results show that your wife has come in contact with the herpes and CMV viruses at some point in the past and certainly not recently. These old infections cannot possibly be the cause of the latest miscarriage. Recent viral infection is indicated by rising levels of the IgM antibodies. These were negative in your wife’s case. Another thing: These infections do not cause recurrent miscarriage. I am puzzled as to why your doctor even considered giving you those anti-viral medications. They will serve no useful purpose. It is indeed the case that if she was to have a flare up of herpes lesions, medication can be prescribed to moderate the symptoms and try to shorten the episode. The medication is taken for a week or less but it is not necessary. The important point to take from here is that these are almost certainly not the cause of the pregnancy losses your wife has suffered and the medication prescribed will serve no useful purpose. Your choice of doctor is of course your prerogative. Best wishes for the future.
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