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Is my wife getting the right treatment?

Q: My 25 years old wife missed her period for two days and was found positive on pregnancy test. But she has slight brown discharge for the last two days. We have a four years old daughter also who during the gestation period suffered from low amniotic fluid at the age of 6 months in utero. Now she is all right. We have consulted a doctor, who prescribed Duphaston (10 mg) twice a day and Adiprin-EC (100 mg) (acetylsalicylic acid) once a day, folic acid and multivitamin. She is experiencing pain in the lower abdomen. The doctor told us that it is due to gas. We are first cousins with the same blood group (B+). Will the same blood group affect the pregnancy? Is my wife on the right treatment?

A:The doctor is probably thinking in terms of threatened abortion - that is, at risk of abortion. So these medicines have been prescribed, probably empirically. 100mg of acetylsalicylic acid is given in pregnancies with some problems - like APLA + cases, and those at risk of high blood pressure during pregnancy or small for dates baby (IUGR in medical terms). I don't know the indication of prescribing acetylysalicic acid in your wife's case - even though it does not have any deleterious effect on mother or baby.

I would suggest a blood test for beta HCG and a repeat one 48 hours later. Depending upon the values one can get a good idea of the pregnancy - is it progressing well, is it outside the uterus (ectopic pregnancy, etc). Depending upon initial value I would advise a transvaginal ultrasound of pelvis.

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