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What precautions are required after repeated abortions?

Q: My 20 years old wife's blood group is B- and my blood group is B+. My wife had an abortion after two and a half months of pregnancy. The doctor suggested her to take Anti-D injection, which she took. She got pregnant again but no heartbeat of the child was found in the sonography and another abortion was done at 2 months of pregnancy. What can we do to avoid such a problem again? Please advise.

A:In an Rh negative pregnancy, once two abortions have occurred, the next pregnancy should be planned after a gap of 6 months-one year. The testing should be done by ICT (indirect Coombs' test) to see if the titres are high or rising. If negative, then anti-D can be repeated which may take care of mishap in next pregnancy. Once she gets pregnant again, the pregnancy will need to be monitored by repeated testing of ICT levels and scanning by ultrasound to see, if pregnancy is continuing without effects like anaemia/ jaundice / hydrops in the baby. Some of these can be corrected during the pregnancy or even immediately after delivery.

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