Q: I am a 26 years old woman having thalassaemia minor. I had a miscarriage 6 months back because there was no cardiac pulsation. Now I have conceived again. I got my last period 3 months back. As I skipped my periods and was experiencing pain in the lower abdomen I visited the doctor. She prescribed me medicines for 10 days: Emfolic DHA 5mg daily, Duphaston 10mg twice daily, Ecosprin 5mg and Gestofit 200 daily. The doctor asked me to go for sonography after ten days. Recently she examined me by internal sonography (tvs) and again there is no heartbeat found. I am worried and don’t want to go through that trauma again. She also said there is growth in the fetus till sixth week unlike last time. She suggested another sonography after 3 days and put me on the same medicines for the next four days. I want to have this baby, is there any scope? Please advise.

A:You will need to have a urine pregnancy test done and a repeat scan after 2 weeks - TVS scan to look for heart beat, maybe along with a Doppler detection of heart beat to be sure that it is present or absent. If the heart beat is present- the same medications can continue, along with bed rest and avoidance of coitus. If it is absent, then maybe a repeat miscarriage has occurred and it can be ended by the use of medications like prostaglandins, to end the pregnancy remains, or by a surgical D&C, depending on availability and patients choice. Follow up to find cause of miscarriage and repeat planned pregnancy will need to be done through care in a high-risk pregnancy unit.