Miscarriage : Health Experts

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then this year on 07/2008 I had another miscarriage I was about 6wks and now I dont know if it was because of my abortion that Iam having miscarriages because I want to get pregnant again Iam very regular in my periods and as soon as I try to get...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:August 12, 2007
this could be another early pregnancy, it could be an ectopic pregnancy, or ot could be choriocarcinoma arising from your pregnancy in December. I am sorry, but it does sound like you had a very early pregnancy loss - sometimes referred to as a...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:March 16, 2007
in immediate danger, even if she has an ectopic pregnancy, so the prudent approach in situations in which the pregnancy is desired is to simply wait, repeat the hCG levels periodically, every 2-3 days, and perform an ultrasound to look for...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:December 22, 2007
All the symptoms continued and the sickness and dizziness, hunger etc seemed to get stronger but then going back to the day after the positive pregnancy test i was told to go to hospital to see gynacologyst, when they did a urine test and a blood...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:March 15, 2007
Recurrent Early Pregnancy Loss - 1 - Implantation. 1) Endometriosis/adenomyosis is probably a MUCH mote common cause of recurrent early pregnancy loss than most physicians are aware of. Factors that contribute to recurrent early pregnancy loss...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:March 22, 2007
Before I get into details regarding specific abnormalities of the maternal immune system and clotting system that appear to be related to recurrent early pregnancy loss, let me tell you a story about one of those special patients in my life who...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:April 3, 2007
Microdeletions of this portion of chromosome 22 are clearly associated with congenital heart defects, especially conotruncal defects, such as Tetralogy of Fallot, that have narrowing of the pulmonary artery and ductus arteriosus and...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:February 7, 2007
Recurrent Early Pregnancy Loss - 7 - Immunologic and Hematologic Causes. Indeed, the triad of recurrent pregnancy losses or poor obstetrical outcomes (related to severe preeclampsia, intrauterine growth restriction; fetal deaths, and preterm...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:April 5, 2007
The blighted ovum was very likely to be a chromosomal abnormality as well and trisomy 16 is actuallly one of the more common chromosomal abnormalities that results in early pregnancy losses (those babies rarely get past 8-9 weeks) So, your...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:March 25, 2007
To begin our discussion of actual causes of recurrent early pregnancy loss, lets start with the one that is probably the most commonly touted, though still the least well-understood (and to me the MOST confusing) HORMONAL CAUSES.
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:March 24, 2007
1.in 17th week, 2.In 25th week and 3.was a preterm birth in 24th week - the last one was a twin pregnancy I have this Prothrombin mutation and take Low Molecular Weigh Heparin during pregnancy plus baby aspirin,Progesterone, and Predisone (5mg)...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:August 17, 2007
Im 22yrs old and recently found out i was pregant,This will be my 4th pregnancy,my other 3 ended in miscarriages and they were 2 my ex at the time,now with this pregnancy im worried i will miscarry again,i havnt had tests as 2 why i have...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:September 17, 2007
Repetitive Miscarriages: I understand how hard it is to undergo repetitive miscarriages, since my first 3 babies ended up the same way, but at this point the hormonal support and aspirin are a reasonable first step.
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:December 6, 2007
So what you are saying if the father has say A- blood type and the mother has a postive blood type there wont be no need for the shot.Its only givin if the mother is rh negative correcet.I was just wonderin cause my blood type is a+ but we dont...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:February 14, 2007
Women with single MTHFR polymorphisms do not need special treatment unless they have pregnancy problems that seem to be related to this. If you continue to have miscarriages, prophylactic heparin or lovenox can be started as soon as a pregnancy...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:September 7, 2007
The risk of the amniocentesis is probably only a tenth the risk of your having a baby with Down syndrome, but with the odds you quoted to me, if you did happen to lose the baby, and the loss was related to the amniocentesis, the odds are that you...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:April 27, 2007
PAI-1 - 55 which had tapered from 141. Many women carry one dose (heterozygotes) for the MTHFR A1298C and PAI-1 4G polymorphisms and have no trouble at all with pregnancy. Lastly can we keep PAI-1 level test as the marker from 15th week for the...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:November 5, 2007
The other day, tjtiger left a new comment on my post "MTHFR Mutations and Congenital Heart Defects" Her many questions made her comment worthy of a post of their own and the query related to the possible assocation of MTHFR polymorhisms and...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:October 3, 2007
Her specific question related to the possible role of plasminogen activator inhibitor 1 (PAI 1) activity and polymorphisms in recurrent pregnancy loss. I was told before my fourth loss by my hematologist that PAI 1 levels become elevated very...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:September 30, 2007
The readers who sent in the comments below related to recurrent early pregnancy loss (RPL) have what we could consider to be 'borderline' indications for 'treatment' and several questions related to their therapy.
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:December 9, 2007
Readers' Featured Comments/Questions - Why Wait to Conceive after Miscarriage and Rh-negative Concerns. Dr- i just had my third miscarriage and the first one, i didn't have tested, the second one was a partial mole pregnancy and after the waiting...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:September 4, 2007
This is not at all unusual in early pregnancy losses, especially if a chromosomal abnormality was present, however, it can also be difficult to differentiate from a condition called "molar pregnancy. I didn't take any drugs during this pregnancy...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:December 18, 2007
i am 42 and currently 12w1d with twins.baby B "looks" normal.baby A has cystic hygroma.lots of fluid behind the neck, in the abdomen, and all over it's body underneath the skin.doctor said baby A has a 95% chance of dying in utero.i burst into...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:August 22, 2007
Thanks to the many desperate patients I have had with advanced cervical change in midtrimester (generally, at 24 weeks or less), no evidence of overt infection. The series of comments below help you to understand the physicians thought processes...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:March 1, 2008
Most importantly, for purposes of our discussion here, among women who received metformin before conception, reductions in insulin and plasminogen activator inhibitor activity were correlated (r = 0.65; P = 04) Thus, metformin alone appeared to...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:November 20, 2007
Her fascinating medical history stimulated my interest in both recurrent pregnancy loss and the role of an appropriate immune response in pregnancy success. Prednisone therapy during pregnancy is associated with increased risk for gestational...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:September 27, 2007
Recurrent Early Pregnancy Loss - 5 - Introduction to Immunologic Causes. The last two major categories I would like to discuss related to recurrent early pregnancy loss are. In the next post, we will address specific abnormalities of the maternal...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:April 1, 2007
That is a high risk for Down syndrome and somewhere between 3 to 10 times higher than the risk of amniocentesis. By the textbook, things look a little scarier, but the odds are in your favor the baby is chromosomally normal - and if you cannot...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:July 19, 2008
Following our readers comment, I provide general information related to fondaparinux and, specifically, to its use during pregnancy. With all that said and done, how should fondaparinux be used during pregnancy?
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:April 17, 2008
If the AFP is abnormally high, and there are no apparent abnormalities of the baby to be seen, then that "false positive" result may actually reflect an underlying placental problem (that may not manifest itself as a problem such as fetal growth...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:September 1, 2007
Most patients who have recurrent early pregnancy loss are desperate to try anything and everything to achieve a successful pregnancy. Regardless, with your history of recurrent early pregnancy loss and your diabetes, I would strongly suggest you...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:April 12, 2007
Patients at risk for or suspected of having Ashermans syndrome, who still have pain occurring at the expected time of menstruation in the absence of significant or any menstrual flow, may have obstruction of the cervix by scar tissue and are then...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:June 10, 2008
With regard to recurrent early pregnancy loss, however, the anticoagulation properties of lovenox and aspirin may be LESS important than their roles in improving trophoblast. If you pregnancy losses are indeed related to a "clotting problem"...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:January 26, 2008
Indeed two recent publications clearly show no direct relationship between the FSH level and aneuploidy risk (Massie, et al. My question to you, in view of your Hashimotos disease and elevated FSH) is have you been screened for any other...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:July 1, 2008
In addition to sperm aneuploidy, other parameters of sperm evaluation, DNA fragmentation and high DNA stainability, have also been correlated with both abnormal sperm morphology and recurrent pregnancy loss.
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:February 3, 2008
Management of an Rh-Isoimmunized Pregnancy. This is very interesting.I've been concern with my pregnancy (I'm 28 weeks pregnant) This is my second pregnancy and with my first pregnancy my baies blood got mixed with mine and now I'm positive with...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:February 23, 2007
Trofatter, This posting is timely as I have just received back my results of the first trimester screening and received a positive with a risk of 1:33 for Down's. Many women with your risk in first trimester simply opt to have a careful...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:March 30, 2008
Robertsonian Translocations. Individuals with Robertsonian translocations can have these as the result of a spontaneous event occurring during the meiosis (in either parent) that produced the egg or sperm from which they were made, shortly after...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:August 29, 2007
First trimester screening for aneuploidy, or as it is commonly referred to as combined first trimester risk assessment, has gained widespread acceptance in other developed nations over the past decade, and is slowly coming into its own here in...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:December 13, 2006
hemangioma.the health team plan to aspirate the"tumor" which is located originally in the cheek but is now down in the left lateral neck region.the mass usually was tender/soft but my son got high fever (up to 39.5 C, the soft mass became hard,...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:November 28, 2006
Cervical Incompetence and Cerclage - 5 - Cervical Assessment. If the past obstetrical history raises some doubt as to the diagnosis of cervical incompetence, or if the patient simply prefers, the alternative is to serially follow cervical length...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:September 1, 2008
The questions are excellent and summarize the concerns of many of our readers who have a low PAPP-A value detected at the time of first trimester screening for aneuploidy, so I thought it worthy of a full post.
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:March 27, 2008
Invasive Diagnostic Testing after Reassuring First Trimester Screening for Aneuploidy. today, but after a brief ultrasound (I don't recall him looking for any specific markers) and reviewing my first trimester screening results he said that...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:January 22, 2008
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