Q: I am a 31 years old woman who has had 3 miscarriages in the last 3 years. I don't know the cause of my first two miscarriages, but my last miscarriage was due to triploidy. I am also suffering from hypothyroidism and have been taking thyroxin for the past 3 years. My LMP date was 27 days back. I have been getting very scanty periods, which lasts for about 2 to 3 days only. My periods are regular and thyroid is also under control. Now I think I am pregnant again as my breast has become tender and heavy. I am worried because I have not taken care of myself in these months. I have not taken any multivitamin or folic acid regularly. I do not want to have a miscarriage again. I am a flight attendant by profession. Please suggest what precautions should I take.

A:After you have confirmed that you are pregnant, you need to start folic acid 5 mgs per day for 3 months, take enough rest, avoid coitus, avoid lifting weights and also avoid long journeys including flying especially in the first three months, you could arrange to have lighter ground duty, with less mental and physical stress. A comprehensive care in cases of repeated abortion also includes empirical use of injection HCG 5000 units IM every week for 16 weeks, tests to rule out diabetes, urine infection, thyroid control, and regular scanning to see that the mouth of the cervix is not opening - in which case a stitch can also be put to maintain the pregnancy. Psychological support, from family or friends or psychologist also helps to reduce stress, which is common in such cases.