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My fetus has no heart beat, would giving hormones help?

Q: I am 30 years old. I have a 5 years old son. I got pregnancy 90 days. The ultrasound scan revealed that there is no heart beat formed for the child. Gynaecologist advised for some hormone injection but I started getting bleeding and D&C was done. After the first period now I have got pregnant again. It is now 45 days over and the first scan was done but still the heart beat was not heard. The doctor has suggested some hormone injection. Will that supplement or help in forming the heart beat. Will the child will be free of complications; what precautions do I need to take?

A:At the outset I must reassure you that since you have one normal child, there could be nothing drastically wrong with you reproductive system. There is nothing to suggest that there is anything wrong in your body or in your child bearing capacity. Therefore it is not logical to give any medicine to help you carry the next pregnancy. Normal women can have one (like you had last time) or more abortions. Pregnancy failure is common in all women and the commonest cause is that the baby is not formed properly. Any baby formed which is less than perfect will not be kept in the womb for nine months. As you saw the last time if the baby is not formed properly the heart beat will not come. No drug, vitamin or hormone can change that since the formation or the baby and normality or abnormality is decided much before you even know that you are pregnant. Whether you carry this or any other pregnancy depends on whether the baby you have already conceived is normal or not and not based on drugs like hormones and precautions like bed rest. In evidence based medicine there is no proof that any drug available currently in the market increase your chance of a normal baby after the pregnancy test has come positive. Most early abortions (in the first three months like you had last time) occur as a form of basic Darwinism or the theory of natural selection i.e. the fetus which is not perfectly formed is aborted. This happens on the day of conception. We know that nearly 20-30 percent of all sperms are abnormal and probably as many eggs are abnormal and if one of these mate, the fetus formed is not ok and is aborted. This has happened since times immemorial but are being increasingly documented now. Before the ultrasounds and pregnancy tests came they used to pass as delayed periods and are now labelled abortions. The net effect is that it has no relation with your previous two pregnancies (one successful and one unsuccessful... one normal 5 years old child and one earlier abortion). Your chance of having a successful pregnancy is exactly the same (which is about 75% now... and more than 98%, once the fetal heart is seen (usually by 7 weeks). What I am trying to say is that you are not abnormal and whether your pregnancy is normal or not will be known by 7 weeks, meanwhile no drug or hormone needs to be taken except Folic acid (a vitamin B group vitamin) which may help to prevent certain kinds of abnormalities and should be taken by all women planning a pregnancy. Meanwhile you can read about all this on the RCOG (Royal College of Obstetricians and Gynaecologists) site under the heading good medical practice and abortions. If you write the details of the drugs you have been prescribed I will be able to answer specifically if they have a role or not, and your anxiety about the possible harmful effects of the hormones if you are indeed carrying a normal child is understandable, so as you see the hormones are not proven to be helpful and their safety cannot be assured the best is to just repeat the ultrasound in two weeks and see if the fetal heart has appeared; if the fetal heart is ok the pregnancy will continue in as many as 98% cases and vice versa. And this is irrespective of the treatment.

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