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How to deal with a failed early pregnancy?

Q: The first day of my last period occurred 2 months back. I was put on treatment with BCrip, Aloes Compound tablets. I was asked to stop taking BCrip on day 15. On the 37th day the doctor confirmed my pregnancy with the card test. (Even I too tested on my own and got it confirmed). In the 7th week she wanted me to get scanned. On the 50th day I went there and she said that nothing is visible in scan and hence she wanted me to get scanned after a week. After that week I had severe stomach ache for a whole night. When I again went to hospital she said after scanning that there is no pregnancy. Again she confirmed it using the card test. Where would have my baby gone. Is there any special treatment required to make the baby grow soon after it has been confirmed for pregnancy. She says that it was because of the elevated prolactin level that the pregnancy did not stay. But I haven't yet got my periods. My prolactin level was 46.05 ng/ml. It was tested a few days before my last periods. She now addresses that it is endometrial hyperplasia. Everything is ready for procreation but the baby is not there.

A:To give a proper opinion in your case one would require a lot more information than you have provided. What is the problem with you? Is it hyperprolactinaemia or is it PCOS, which will also show a raised prolactin level. In the absence of a firm diagnosis, all I can say is that your case seems to be of a failed early pregnancy. You wrote that the pregnancy test now is negative. Please be sure about that (probably confirm by a repeat test because if it is still positive it could be an ectopic pregnancy - which is a serious problem). Probably the best thing to do is to do a Beta HCG test in blood to confirm. Either way if the pregnancy test is negative then either you had a false alarm meaning the test was falsely positive (which can happen especially if you had injections of HCG). If it was definitely positive then you have had a very early abortion, which was so early that you did not even notice the loss of the embryo. This is how most early abortions happen and about 20-30 years ago these were noticed as delayed periods. But now that the tests are so sensitive they pick up pregnancy very early and we know that as many as 45% pregnancies or more abort like this. This is a natural process and only an abnormal fetus aborts or if there is a major problem in conception. The treatment to ensure that this does not happen cannot be given without a firm diagnosis. To make a definite diagnosis one would require more information about your case. It is not clear to me that if indeed you had hyperprolactinaemia why did you stop bromocriptine so early? Bromocriptine is relatively safe drug to take in early pregnancy and if you really have hyperprolactinaemia you should probably take it longer than you took this time. Either way the treatment will depend upon a firm diagnosis, anyway I think you need a re-evaluation of the whole case and treatment would obviously be according to the diagnosis. There are a lot of treatments being offered in the form of bed rest to hormones and vitamins and now immunotherapy, many of which are expensive, unproven, useless and sometimes harmful. The royal college has issued a firm warning against such irrational therapies and please avoid these. I want you to understand that if the fetus is conceived normally, 97% of the times it results in a normal baby and vice-versa and rare if ever anything can be done to change that. In case an abnormality is detected you need to know if it has an evidence based study showing that its treatment works or not? And only if it is there should you even try. In the absence of such an evidence avoid all treatments and give nature a chance. The logic that something must be done is, some treatment is better than no treatment, is not acceptable in pregnancy, since most treatments are potentially harmful. Remember that if there is a choice between no treatment and bad treatment, no treatment is more acceptable. Please see that what you get is scientifically proven after a proper diagnosis. Confirm that you can read all about it on the Internet or in a book. Meanwhile if the pregnancy test is negative (on repeat test) take a progesterone withdrawal to bring on the periods and start treatment all over again.

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