2 times abortion: complications in pregnancy

[blessingsalways]

i am 29 years old, i had first abortion as it was a silent miscarriage, i lost my baby in 12th week of pregnancy (heartbeat stopped) it was a partial mole pregnancy, i got pregnant 4 months later and every thing was smooth, in 21st week dr. said baby has spina bifida and asked me to abort. Knowing the complexities of living with a special child i took a hardest decision of my life and i had pre term delivery. now its more then 7 months i am scared to think about a pregnancy again. as all the tests for me and my husband were normal- genes, chromosomal, karotype etc which could have led to these issues. my doctor says take these as accidents and think about the next pregnancy. As i am young to think about IVF or surrogacy. Also I am an Indian settled in Gulf country after my marriage (3 years) Doctors said the environment doesnt suits me and asked me to move back to my home country. I will be moving back next month. Please suggest..

[GingerAcorns]

Hi,

I am terribly sorry to read your story. Please accept my condolences for both of your losses.

Unfortunately you do now have an increased risk of a future pregnancy having a similar complication. Research suggests that your risk of another molar pregnancy is around 1-3 in 100 although you have had the genetic testing which was all normal and so I hope that this alleviates some of the anxiety for you.

Your risk of conceiving a baby with spina bifida or another neural tube defect is also slightly raised but you can do something to reduce this risk. Folic acid taken pre-conception and then continued during pregnancy significantly reduces the incidence of neural tube defects. I would recommend that you ask your doctor to prescribe you a higher dose of folic acid (5mg) as you have had a previous pregnancy affected by spina bifida. You should also increase the amount of natural folate you consume in your regular diet. Folate is found in foods such as: broccoli, peas, asparagus, sprouts, chickpeas and brown rice.

While you have had two previous difficult pregnancies, if you feel ready to you should try again. If you still have anxieties I recommend you visit your GP again to talk them through.

I wish you all the best.

[Darinak]

Hi there,

Really sorry to hear about you losses.

Have you been tested for MYHFR polymorphism and thyroid function?

If you have MYHFR polimosrphism there is an increased risk of mural tube defects and miscarriages. That gene mutation is very common (more than 40%) of the population have it. If you have it you can't utilise the synthetic folic acid whic is the one included in 90% of the prenatal supplements and the one that actually all GPs recommend taking . supplementing with folic acid can be very harmful for people with MTHFR polymorphism, because it builds up in the blood and can lead to many health problems. Those people should go for the already methylated form of folate- methyl folate or folinic acid.

Regarding the thyroid tests- it's not the normal test which your GP usually performs - only TSH. more comprehensive test can reveal the truth about the state of you thyroid- include: free T3/T4 , TPO antibodies and reverse T3. Problems with the thyroid have been overlooked from most of the fertility clinics and it is actually a test which should be performed straight away, before anything else. There are women with history of 3/4 unsuccessful in vitro tries , and nobody offered them that vital test.... That doesn't mean that all miscarriages and neural tube defects are due to thyroidism but there is a strong link between untreated thyroidism especially during the 1st trimester and higher risk of autism spectrum child, Dawn syndrome and ADHD!

I think comprehensive thyroid screening should be offered to all women pre, during and post pregnancy.