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Pregnancy Bliss | Reproductive Health Hub

Immunotherapy for recurrent miscarriage

Question: I am 37 years old, I have had 7 miscarriages, extensive work up has been done to include lupus panel, anatomic uterine defects, fetus analysis for chromosome abnormalities, and I was found to have endocervical polyps (which were removed) and presumptive cervical incompetence, i had a cerclage, I was placed on lovenox on my latest pregnancy and made it until 24 weeks, previous pregnancies only survived until week 9-12, except for 2 of them at 24 weeks.
I recently heard about the sensitization of mothers against fetus blood antigens and I wonder if this has happened to me. I am willing to check myself simply because my husband and I are currently about to have a surrogate carrier for our next attempt.
How can I know if i am sensitize and can I check if my husband carries the antigen, can this be a risk for the surrogate mother to become sensitize as well, if it happens that the fetus inherits one of this antigens . Please respond asap. Thanks. J.E. (USA)

Answer: I will come straight to the point. There is absolutely no evidence that this kind of treatment works. I can go so far as to state categorically that it does not. There is a lot of credible scientific evidence to this effect. Immunotherapy as a way of overcoming recurrent pregnancy loss was a hypothesis put forward on the theoretical assumption that the immune systems of some women who experience this react in a hostile manner to the embryo, leading to its eventual rejection and miscarriage. The hypothesis was attractive and logical as far as it went. However, extensive research has shown no shred of evidence of this. Many practitioners in the last 20 years were so convinced by the hypothesis and went ahead and offered this treatment. None of them has been able to show credible benefit from this treatment to their patients. My view therefore is, you as a couple, should save yourself the substantial financial outlay, time and arguably more important, the emotional distress and pursue a more credible avenue in your quest. It is clear from the details you have provided that you have had a thorough workout and nothing has been left to chance. It is one of those situations where we, as medics, need to have the honesty and humility to state the obvious which is, the cause of your recurrent miscarriage is unknown (that’s not uncommon). The idea of surrogacy is appealing.

Concerned about test results

Question: my daughter has 7 weeks until her due date, her blood test this week showed white blood cells, very high protein and keratins (not sure if spelt correct),she also has been wearing sanitary pads due to lots of discharge, sometimes green, which she has been given canesten suppositories for, I AM EXTREMELY worried, even though the baby is active,my daughter is not eating properly as she is not hungry. She has a visit to see her gp next week and back to the midwife in 2 weeks. Is this normal? Thank you. D.B. (UK)

Answer: Did you mean to say urine test? The results you are describing would normally be of a urine rather than blood test as stated in your question. Assuming that you wanted to say a urine test, well; those results would be inconclusive and the standard advice would be to repeat the test with emphasis on careful collection of the urine sample to avoid contamination from possible vaginal discharge/secretions. The presence of ‘ketones’ simply indicates that at the time of collecting the sample, the person had fasted for some time. With regard to the discharge, I see that the doctors have given your daughter Canesten pessaries which is a safe and effective anti-fungal treatment. It means they think this might be thrush, a fairly common occurrence in pregnancy. There is, of course, a possibility that the discharge she has is not thrush at all and it may simply be a result of increased vaginal secretions, another common occurrence during pregnancy for some women. In any case, the pessaries won’t do any harm.

You have highlighted something particularly important in that the ‘baby is active’. This is the most important yardstick in judging the well being of the baby in the womb. Poor appetite can plague some pregnancies especially in the early weeks and towards the end. At 33 weeks, this would not be entirely surprising.

Whilst there appears to be a collection of niggling issues, the impression I get is that there is nothing specific here to worry about your daughter’s overall health or the state of her pregnancy. She appears to be having general non-specific problems that many women experience especially in the later stages of their pregnancies.

Using amniocentesis

Question:  What’s the need of undergoing amniocentesis? M. (India)

Answer: Amniocentesis is a process whereby amniotic fluid is drawn from the gestational sac using a fine needle. The commonest role of amniocentesis is diagnostic whereby fetal cells found  in the  fluid can be extracted and appropriately processed depending on what is required. In most cases, this is to find out if the fetus may be affected by chromosomal or genetic conditions such as Down’s syndrome etc. Other diagnostic uses of amniocentesis include establishing whether the fetus has been affected by viral or other infections. In some cases, amniocentesis can be used as a therapeutic procedure. This is in cases of severe polyhydramnios (excessive amniotic fluid) whereby some fluid is removed to relieve pressure. It is uncommon to perform amniocentesis for this purpose.

Zinadol (Cefuroxime) in pregnancy

Question:  Hi!I'm a pregnant women in the third month. I made the tests and have come up with some urinary infection and my doctor has suggested the use of tablets zinadol. I like to know if there are negative effects the use of this medication for my baby? I. (Albania)

Answer: Zinadol, an antibiotic the generic name of which is Cefuroxime belongs to a group of antibiotics known as Cephalosporins. Zinadol, like other cephalosporins is safe to use at any stage of pregnancy. Your baby is safe.