Q: My 32 years old daughter had two miscarriages – first was one and a half years back when she was into her ninth week of pregnancy and the other happened a few months back when she was five weeks pregnant. Last week, my daughter went to her internist, who gave her a diphtheria tetanus pertussis (DTP) booster. She had her last vaccination 10 years back. Is it safe to get DTP booster while conceiving? I do not know if having the vaccine could cause any problems to either my daughter or her fetus if she becomes pregnant again soon. She also underwent complete blood count (CBC), lipid profile and gluten test. The doctor told us that she is suffering from celiac disease which can cause miscarriages.

A:I am sorry to say that the treatment and the tests are all incorrect. She should have a workup for causes of repeat abortions which include TORCH, HIV, thyroid, urine culture, ACL & APL antibodies, a hysterosalpingogram (HSG) for uterus abnormality and vaginal swab for infections and also serum progesterone in midcycle. The treatment will depend on the cause found. Tests for diabetes too maybe required. A repeat attempt for pregnancy should be tried only after the cause is found and treated, and with the knowledge that a repeat abortion is likely in over 20% cases. Successful term pregnancy is possible in 80% cases after proper evaluation, treatment and care during the pregnancy,. The centre must be a good one with good monitoring facility for a high risk pregnancy and a good nursery.