Why did I have a missed abortion?
Associate Professor, Department of Obstetrics & Gynaecology,
University Technology Mara,
Malaysia
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.
- No pregnancy for one year after that to give time for uterus to heal.
- After that, evaluation by tests to find out cause of abortion and treatment accordingly before planning the next pregnancy.
- The tests are blood for Hb, TORCH, blood sugar, blood grouping, VDRL, HIV and urine test depending on physical examination findings.
- Relevant tests for any possible infections or hormone disorders.