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What precautions must I take, after 3 miscarriages?

Q: My wife, aged 32 years has had three miscarriages. During the first pregnancy in the 25th week the BP was high and the water around the baby was 2 cm only so the result was a caesarean baby, but dead. The second was a twin pregnancy wherein in the 24th week water levels were low which led to an abortion. Lastly, at 32 weeks the BP was high leading to convulsions in both baby and the mother. This led to caesarean delivery and loss of baby. What should be future precautions?

A:I can understand your fears about trying for another pregnancy. First of all, your wife needs to be investigated thoroughly by an experienced perinatologist BEFORE the next pregnancy to see why she is having early onset high blood pressure and why she is having low water every time. Her BP between 2 pregnancies needs to be checked. Depending upon the results she can tell you the chances of having a successful pregnancy next time. Regarding the number of cesareans, many women have three cesareans, some 4 or 5!! You need to have your wife under the care of an obstetrician who is attached or works in a large hospital, with all allied specialities, an adult and neonatal ICU and an experienced neonatologist and anaesthetist. Good luck.

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