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Why did I have a missed abortion?

Q: I am a 31 years old woman and had my last menstrual period 4 months back. During the second month of my pregnancy my scan revealed the size of gestational sac as 1.6 cm corresponding to 6 weeks and 2 days, and CRL measured 1.34 cm i.e. 8 weeks 1 day, fetal heart rate was 176 / mt. Impression - there was disparity in the gestational sac size and CRL. The doctor suggested that I wait for a month before the next scan. But fifteen days back I had bleeding and the scan report stated single irregular gestational sac diameter (MSD) was 2.92 cm, corresponding to 7 weeks and 6 days. No sub chronic haematoma, fetal pole and yolk sac seen, crown rump length 1.77 cm, corresponding to 8 weeks and 2 days, cardiac activity not made out, uterine mymometrium appeared normal, cervix appeared normal, internal os was closed, right ovary measured 4.67 x 1.67 cm, left ovary measured 4.18 x 2.12 cm; both ovaries appeared normal in echotexture. Findings suggestive of missed abortion. My thyroid and polycystic ovaries are in control. What could be the reason of this abortion? I have undergone dilation and curettage (D&C). Is this going to continue in my future pregnancy? What should I do prevent the same problem in the future?

A:The aborted pregnancy has to be evacuated with medicines like prostaglandins and miphipristone or by a surgical evacuation.

  1. No pregnancy for one year after that to give time for uterus to heal.
  2. After that, evaluation by tests to find out cause of abortion and treatment accordingly before planning the next pregnancy.
  3. The tests are blood for Hb, TORCH, blood sugar, blood grouping, VDRL, HIV and urine test depending on physical examination findings.
  4. Relevant tests for any possible infections or hormone disorders.
In 30-40% cases no cause maybe found-fetal abnormalities could also be a cause. In future pregnancy - need to have early testing, rest, no sex, and hormonal support with progesterone and HCG injections to stabilise the pregnancy. Success can be achieved in over 85% cases next time.

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