Friday, 15 March 2019

How best to treat a case of Recurrent eraly abortion??


What other investigations?? ATA, .Homocysteine...AMA, ANA consider hysteroscopy workup can be done.  Uterine septum is one of the main causes of RPL. karyotypic of conceptus is debatable.  Due to that septum, there is no vascular supply n due to that embryo grows only up to 6-8 wk n then abortedà .so go for hysteroscopy also!!!
 Uterine septum is one of the main cause of RPL. Due to that septum ,there is no vascular supply n due to that embryo grows only upto 6-8 wk n then aborted. so go for hysteroscopy also!!! Many prefer starting prophylactic LMW heparin in these  patients, Some use Inj Bharglob as well (causes production of immunoglobulin in body)/  LMW heparin LMW Heparin to start after confirmation of intrauterine pregnancy by USG
. Empirical heparin with good progesterone support.One can rarely try DHEA 75 mg for 3 month n then plan for conceive

 1 mg /kg body weight of Enoxaparin, till 38 weeks of gestation
If  Apla is normal LMW heparin may not work but can be tried, Put her on L-methyl folate instead of Folic acid at least a month prior to planning conception and on confirmation of pregnancy try immunoglobulin- Bharglob 16,5% 1 ml. 2 inj at 21 days interval.
. Any environmental/ food ./ domestic pollutant-passive smoking , &  professional pollutant affecting may affect spermatozonesis/oogenesis.





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