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Pregnancy Bliss | Reproductive Health Hub

Threatened miscarriage and anti-D

Question: Hi, my wife had experienced this and she had a miscarriage last year. And at the moment she is in the same problem, she called me at my small kiosk crying for help, she is having a lot of pain and she is bleeding. Please help i don' want to loose her, we cant afford a scan at the moment, and her blood group is 0 negative. She didn't get that injection in her first birth in the year 2005. Please help. PMK (Kuwait)

Answer: I'm unsure as to the type of help you are asking for. From your narrative it appears you are concerned your wife might be having a miscarriage. You have not said how many weeks gestation she is. It is never possible to influence a threatened miscarriage. The only intervention that can be made is pain relief to keep the woman comfortable. You cannot stop a miscarriage from happening if it was to happen. That's never possible. With regard to her being being blood group O Rhesus Negative, that may be of no immediate concern if she is less than 10 weeks gestation. It is only beyond that stage of pregnancy that an anti-D injection is required in cases of vaginal bleeding. That is on the assumption that she did not develop antibodies following her first pregnancy six years ago. Remember that is not inevitable.

I hope your wife will get the medical attention she requires but please be aware that this will only be supportive to keep her comfortable. No medical intervention can influence the outcome. My best wishes.

Stillbirth followed by early trimester miscarriage

Question:  10 months ago my son was still born at 27 weeks following a placental abruption. The diagnosis afterwards was that I may have had pre-eclampsia but it remained undiagnosed. This weeks I have suffered an early miscarriage at 6 weeks and although the nurse insisted it is unrelated, I am finding that really hard to believe. Should I be asking for more tests before we try again? H.T. (UK)

Answer: This has clearly been a most stressful time for you. The question of the two incidents being related is not straight-forward. On the face of it, it is difficult to see how a placental abruption ostensibly secondary to pre-eclampsia, could be related to a pregnancy loss occurring so early in the first trimester. Pre-eclampsia is a disease of relatively late pregnancy and its influence is not manifest so early in pregnancy. The advice you got therefore has a good chance of being correct. However, I’m unsure whether the conclusion that was made following the tragic stillbirth 10 months ago was based on solid evidence. If that is the case, it is possible to construct a hypothesis of an indirect relationship between the two events. That will be based on the assumption of an underlying condition namely anti-phospholipid syndrome (APS). This condition is mainly associated with recurrent early trimester miscarriages but other pregnancy complications are associated with it. These include intrauterine growth restriction, pre-term delivery and stillbirth. With that kind of assumption, you can make a case for a connection between the two events. However, you can understand why many would consider such a hypothesis a bit of a stretch and I am tempted to be of that view too. My best wishes for the future.

Threatened miscarriage; previous pregnancy termination

Question:  I had an abortion (I was raped) in march 2010, with a d and c. I'm pregnant again 7/2011 with a the love of my life! Yesterday I woke up with period like cramps, and medium bright to dark red bleeding. the cramps stopped last night, and I only have bleeding like a light period. My cervix is still closed, breasts are sore, and I still feel the soreness all over like pregnancy. I have an appt, but not for 10 days! I have resigned myself to the fact that my baby is dead, but wonder if there is a chance that I didn't lose the baby? And if I did, could the abortion be the cause of it? Thank you so much, I’m just going crazy and hoping that just maybe my baby is still safe inside me... J. (USA)

Answer: I appreciate this may be difficult but you need to try and avoid allowing anxiety to overwhelm you.  The fact that the abdominal cramps have ceased and the bleeding is now only light with a closed cervix means this can only be legitimately described as a threatened miscarriage. You will be aware that only 1 in 10 of threatened miscarriages actually end up being thus and the rest resolve spontaneously and carry on. This is a good reason for you to have hope. I can state categorically that your previous pregnancy termination has nothing at all to do with what is going on now. I hope it all works out well in the end for you.

Fibroids and pregnancy

Question: I am pregnant woman 25 weeks now. I have got multiple fibroids. I am really concerns about my baby, I want to know is my baby growing properly because of fibroid? My belly is really bigger for that reason. Please let me know. R.A. (UK)

Answer: You really don’t need to worry. Fibroids don’t usually interfere with fetal growth. Issues that arise with fibroids in pregnancy include pain which can happen as a result of a fibroid undergoing degeneration. This is uncommon. Another issue that might arise at the end of the pregnancy is that, if the fibroid is inside the womb cavity, it may make the baby lie in an abnormal position making vaginal delivery impossible thereby necessitating a caesarean section. Your current concern on growth is rarely an issue with fibroids.

Previous postnatal thrombosis

Question:  When I was 30 I gave birth to my second child and that night I had a complication, it was a thrombosis. Now I am nearly 38 and I am pregnant {five weeks}. My question is because I am afraid is it possible to happen again that kind of complication? What are the chances to be repeated again the thrombosis? A. (Serbia)

Answer: When there is a history of thrombosis in a previous pregnancy (and that includes the immediate postnatal period), that is regarded as a risk factor as far as this condition is concerned. As such, it is imperative that preventive measures are seriously considered in any subsequent pregnancy. The fact that you are now older will also be regarded as an additional risk factor. If you are heavier than you were 8 years ago, that will be another risk factor for thrombosis, especially if your BMI is over 30. A history of post-partum thrombosis on its own is often sufficient to justify prophylactic measures. Looking at the overall picture, you should ideally be on low molecular weight heparin injections as soon as possible and the injections should continue throughout pregnancy and for at least 6 weeks after the delivery. You need to discuss this with your obstetrician. If overall assessment indicates that prophylaxis during pregnancy is not necessary, you need to ensure that this is definitely given in the 6 weeks postnatal period. However, I wish to reiterate that, with the information you have given, I would almost certainly offer prophylaxis during pregnancy starting now.