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Missed Abortion
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 Frequently Asked Questions

Q: My friend had a missed abortion. After a number of tests, they were finally advised to go for AIH test. What is this test all about and what is the cost and success rate of this test.

Kiran (Hyderabad, India)

A: AIH stands for artificial insemination husband. It is a process by which we selectively transfer a concentrated amount of washed semen into the woman's uterus---IUI---intra uterine insemination. In the sperm wash only high potency, highly motile sperms are selected for insemination, so the chance of conception is high. This procedure will not work if the mobile sperm count is less than 2.5 million. I would also like to quote this from a famous book on male fertility; “If varicocoel repair fails to restore fertility then other causes of male fertility should be looked for, as just treating varicocoel for male infertility leads to a treatment failure rate of 50 to 70%. It usually takes 3 to 6 cycles of insemination into the uterus---IUI by AIH. The cost is variable from institution to institution. A large number of infertility centres in Mumbai and Delhi have a good success rate.

Dr. Sahni

Q: Ater desperate trying for three years, finally my wife got pregnant last year. But unfortunately she had a missed abortion. Due to this, she has become extremely weak. What could the possible reason be for having a missed abortion. Will she experience any serious problem due to her weakness? Please advise, as I am really concerned about her health.

Bhavesh (Vishakapatnam, India)

A: Sorry to hear about the missed abortion. Some studies have shown that one out of every 4 pregnancies gets aborted, often even before the women even knows she is pregnant. A missed abortion is nature's way of terminating something that was not likely to result in a normal delivery. There are very often no reasons for this occurrence. It is important that your wife takes plenty of rest and gets backs to being healthy again, because although she was only pregnant for a short time, her body has gone through enough hormonal changes, almost as much as going through 9 months. Unless there is a family history of genetic defects, at this stage you should not be worried about any serious problems. If subsequent pregnancies also end in miscarriages, then there a cause for concern and your doctor will then ask you and your wife to undergo a series of test.

Dr. Sahni

Q: I recently had a missed abortion. My husband loves kids. But was very worried seeing me going through the pain of misscarraige. He gets very tensed. Due to this, we did not have an intercourse for almost six months. Now, when we actually want to have sex, he gets aroused during the foreplay and his erection dies down just before intercourse, and he is unable to penetrate. Why does this happen? He also gets scared that if I get pregnant, I should not have an miscarraige again. More than me, I am more worried about him. Will I be able to conceive again. Please advise.

Jane (Melboune, USA)

A: Let me assure you that a number of couples go through what your husband is going through after a loss in the form of an abortion. I think what is preventing him from getting an erection is undue anxiety and tension. He needs to relax and enjoy sex rather than thinking in terms of another abortion and its consequences. The first pregnancy ending up in a missed abortion can be a very traumatic experience and may affect your future sex life if he doesn't relax while having sex. Missed abortions usually occur due to a genetic cause. The foetal development is not observed and foetal tissue is absent on histopathological examination. Certainly you can conceive again and hopefully have a successful pregnancy outcome. I advise you to visit your gynaecologist and have a battery of tests done – just to be on the safe side – before planning the next pregnancy.

Dr. Sahni

Q: My periods stopped two months ago. The doctor confirmed my pregnancy. But a week after the conformation, I started bledding and had a blackish discharge instead of the normal red. My doctor said that this could be a sign of a missed abortion. He did a sonography but there were no signs of the foetus - the sac was empty. But I am still not satisfied with his peprt as I still feel the baby within me. The doctor has asked me to wait for another one month before doing another ultrasound. My periods have always been regular in the past.

Ambika (New Jersey, USA)

A: Blackish discharge is indicative of a missed abortion, especially since you have written that the ultrasound report shows an empty sac which may be indicating an anembryonic pregnancy (where the foetus is absent) and it needs to be terminated. Since your pregnancy was confirmed, yes, it would be advisable to go in for a repeat ultrasound after 15 days in order to rule out delayed conception in the next cycle (i.e. after the one you thought in which it occurred). However, if on the repeat ultrasound, it is diagnosed as a case of missed abortion then you will have to go in for cureting. If diagnosed as absence of a pregnancy, pills may be taken to bring about your periods. In either case, it would be advisable to go in for further investigations.

Dr. Sahni

Q: My wife underwent a D&C after miscarraige. When we got the doctor's report, it said that it was a missed abortion as a result of Partial Vesicular Mole. Can you please explain what this means and also what are the chances of having a succesfull pregnancy again. Please help. I am really worried.

Julian (Chicago, USA)

A: A vesicular/hydatidiform pregnancy can be partial or complete – both of which manifest as abnormal tissue development. A complete molar pregnancy resembles bunches of grapelike vesicles. Foetus, amniotic sac and placenta are conspicuously absent. A partial mole may resemble the placenta but contains a few vesicles on its maternal surface. A foetus is identifiable in this case. In a partial mole, some of the villi appear normal. Molar pregnancy usually occurs in the age group of less than 20 or over 40. Dietary deficiency and socioeconomic factors usually cause this. Generally patients of partial mole present signs and symptoms of incomplete or missed abortion, and a diagnosis is made only after histopathology of uterine curetting. Following partial mole, approximately 4% patients develop persistent tumour, usually non-metastatic, and require chemotherapy to achieve remission. After molar evacuation, the patient should be monitored by beta HCG levels. Patient should not conceive in the follow-up period. Usually barrier contraception is advised. The topic of molar gestation is rather tough to explain, but I have tried to do my best. Feel free to clarify further doubts.

Dr. Sahni

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