Posted by: Shana | 2009/02/02

5th miscarriage

Doc I' m really at my wits end. I had 5 miscarriages:
8weeks Des 2005 (blighted ovum)
14 weeks July 2006 (Ruptured membranes)
6weeks Feb 2008 (no heartbeat)
9weeks (Blighted ovum)
After the above miscarriages I went to a fertility specialist and he diagnosed me with a uterine septum which was also removed in July 2008.

I felt pregnant in Sep 2008 the FS put me on cyclogest and everything went well till 14Jan 2009. I was spotting and went to the hospital there my gynae said my cervix was dilated. A few minutes after I was hospitalised but my water broke. Labour was induced and I lost my 5th child.

My gynae suggested that in the next pregnancy that he gives me a cervical stitch on 13weeks. I also suffer from sinus due to allergies will my constant violent sneezing have a influence on the stitch? My nose ear and throat specialist did prescibed Flomist spray and Allecet tablets which helped but I don' t drink it when I' m pregnant. Should I?

But my question is so many things went wrong with my pregnancies already and it not good for me and my husband' s mental health. What should I do in my next pregnancy should I look for a gynae that specialise in high risk pregnancies and where do I find a doctor like that. Or should I just schedule more visits at my normal gynae more and what tests should he done more for me in my situation?

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Our expert says:
Expert ImageFertility expert

Dear Shana

Your problem is a combination of first and second trimester miscarriages and the causative factors in each are fairly different. I am rather surprised that your gynaecologist did not offer you the encirclage or stitch in your last pregnancy, as this would be highly recommended in patients with a previous uterine septum as well as a previous trimester miscarriage. I would recommend that you undergo careful fertility treatment by way of in-vitro fertilization and consider that option of pre-genetic diagnosis (Pgd) of embryos looking for common chromosomal defect before transferring only the healthy embryo/s in to the uterus (womb). The reason for my recommendation is that all stages of the fertility process should be carefully controlled and monitored as certain treatments, which must be instituted shortly before implantation, during implantation as well as in the first 8-10 weeks after pregnancy has been established. Once your pregnancy gets beyond 10 weeks it would be prudent to insert a encirclage or stitch and to continue monitoring the pregnancy very throughout.

Answered by: Dr M.I. Cassim

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