Q: I am a 28 years old female, working as a dental surgeon. My first pregnancy ended in 33rd week. My gynaecologist did not perform a ToRCH (Toxoplasma, Rubella, Cytomegalovirus and Herpes) test during my first pregnancy. After miscarriage, a ToRCH test was performed and was positive to cytomegalovirus (CMV) and HSV 2 with raised IgG found. Histopathology of placenta showed haemorrhagic endovasculitis. What causes miscarriage? Is it safe to conceive now? My subsequent report showed a declining titre.

A:You need to wait for a year before planning another pregnancy. In the meanwhile, get treated for CMV infection, repeat titres after treatment and once falling or negative can plan another baby. Also test for other infections - HIV, VDRL and urine culture. VDRL can be tested in husband also. Blood grouping of both partners as well can be tested. Make sure there is no maternal diabetes also by testing your blood sugar.

Once all that is ruled out – you can take folic acid for 3-6 months and conceive while on it. An early scan at 10-12 weeks after conception, along with retesting of titres for CMV infection and other ToRCH tests can be done, to make sure it has not recurred. Pregnancy outcome is more successful in over 60-70% after that. Support with progesterone, and or HCG may be required to prevent a repeat miscarriage later on.