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Why did my wife have a missed abortion?

Q: My 24 years old wife had a missed abortion recently and the scan report mentioned - single intrauterine gestation sac is seen with poor decidual reaction, CRL = 25 mm corresponding to gestation age of 9 weeks and 3 days, embryonic cardiac activity absent, cervical canal is closed, both ovaries normal, no adnexal mass seen and no free fluid seen. She was taking Myfol and Gestin twice daily in the first month of pregnancy and later she took Mofololian or Myfolian along with Gestine twice daily. No ultrasonography was done till she got bleeding a week ago. What went wrong during her pregnancy? If she was scanned earlier, could the abortion be avoided? When can we plan for the next pregnancy? What are the chances of reccurrence of the same problem?

A:As many as 10% of pregnancies can end in abortion- most commonly due to a fetal defect in over 60% of cases. It is nature’s decision to eliminate an abnormal pregnancy. The uterus can be emptied by medications like Misoprostol and Mifepristone taken for 2-3 days as per schedule and prescription by a gynaecologist under supervision. Five percent cases may need a surgical procedure if the medicines fail to empty the uterus fully.

For a repeat future pregnancy - before planning the next one, testing to find the cause like blood group, VDRL, TORCH test, blood sugars may be necessary. A year of contraception is advised to help heal the uterus.

A successful repeat pregnancy is possible in over 90% cases.

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