[hshaukat]

Dear Doctor,

Last year I was pregnant for the first time and at my 17th week ultrasound, the doctor told me that the bowel and kidneys appeared to be ecogenic with minimal abdominal ascitis. I tried to be positive and told myself that the next ultrasound will show everything to be normal, but at the 20th week ultrasound, the fetal heartbeat could not be detected and the gestational age was showing at 16 weeks only. Labour was induced and I delivered a premature 20 weeks fetus which was a male.

To ease our minds, the doctor suggested some tests such as Anti Cardiolipin (IGG and IGM) as well as Lupus Anticoagulant which were all normal. In addition, since me and my husband are first cousins and Cystic Fibrosis (Mutation Delta F508) runs in our family, we went through tests to find out if any of us are carriers of that mutation. Results showed that I am a carrier (both normal and mutant alleles of CF were detected) but my husband is not a carrier. Therefore, we decided all was normal and we would try again.

6 months later, I was pregnant again. This time at 6 weeks I experienced some spotting which was red in the beginning then turned brown but continued for 6 days. I had experienced the same thing during my first pregnancy also and after bedrest for a week and using cyclogest for 4 weeks, I was fine and the baby had survived this at least. This time around I was quite positive that the baby will survive the spotting again. I was recommended bedrest and to take cyclogest pessaries twice a day for 2 weeks. At the same time I was also having blood tests to check HCG levels every few days. In the beginning my HCG was increasing but not doubling every 48 hours. I went through an ultrasound at 7+ weeks which did not show any cardiac activity. In addition, my HCG test at this point showed a decrease in levels.

My doctor suggested that I have a choice of either going through a D&E or take medicine which will induce miscarriage naturally. I chose the D&E as it sounded much easier to go through.

Now the question that me and husband have and one that we are asked again and again is that why this happened for the second time and what can we do to ensure that we have a healthy baby next time? Any tests required this time?

[J_9]

I'm sorry if you misunderstood, however there are no OB doctors that are members here. {Mod Note: thread title changed to reflect question-<>}

It is possible you are going through all of this because of your genetic relationship to your husband.

What I would suggest is that you take prenatal/antenatal vitamins or a regular multivitamin every day during your child bearing years. The two of you may also want to undergo genetic testing of a broader spectrum than just the CF.

There is no pregnancy that is every ensured to have a healthy baby, all pregnancies carry risks, it's just that your risks are higher because of the blood relation of you and your husband.