Hello, I would be happy to help you with your question.

So to summarize, you are a 40 year old who is in her third pregnancy (you mentioned the anembryonic pregnancy, the full-term pregnancy, and the current pregnancy). If there are others that I am missing here, please clarify. It is appropriate to have you take folic acid, but the use of dubagest (progesterone) is usually reserved for cases of:

1. Pregnancies conceived using IVF or other assisted techniques
2. In women with a history of recurrent miscarriages (usually 3 or more unexplained first trimester losses)
3. In women with a proven deficiency of the hormone progesterone during the second half of their cycle (called a luteal phase defect)

In some couples with a history of recurrent losses, and no explanation, we sometimes put them on progesterone supplementation at the start of pregnancy and continue until up to about 10 weeks. So based on what you are saying, you don't really fit the profile of someone who needs it, and the length of time that you were told to take it does not make any sense either. That being said, we believe that the risk to the fetus is actually quite small.

Finally, if you decided to stop this medication now, it will not cause a miscarriage. In fact, if you miscarried, I would not blame it on the use of the medication OR its discontinuation.

The side effects of either route are going to be similar, and it is usually well tolerated.

I hope this helps - DR XXXXXXX

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Thank you for the followup. I want you to consider the following:

1. This site is for educational purposes only. While I said that it did not seem to be a strong indication for its use in your case, I don't want you to construe this as "medical advice". It is not medical advice. For the ultimate decision regarding stopping the Lovenox, you should confirm this with your doctor. But given your scenario that you described, it does not necessarily seem indicated.

2. Yes, the folic acid supplementation is completely safe and recommended

3. In women of "advanced maternal age", there is an increased risk of problems related to chromosomes, such as Down's Syndrome. This can easily be screened for in the first trimester, by 12 weeks.

I hope this helps to clarify!!

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In patients where clarification of dating and viability of a pregnancy is in question, and where a prior ultrasound showed a viable pregnancy but dating was difficult to determine based on the small size of the fetus, a followup ultrasound in one week from the prior ultrasound is clearly an appropriate choice.

So, in answer to your question, I think that the scan on 10/13 is appropriate and will add significant information and clarity to your situation. And no, it is not too early to perform the followup.

I hope this helps.

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