Brief Answer:
Please have fortnightly visits to the specialist now.

Detailed Answer:
Hello,

Thanks for trusting us with your health concern.

Firstly, congratulations on your pregnancy. So far, this pregnancy seems to be going good. I would also like to know if you had any tests performed on the abortus in your previous pregnancies and if any genetic defects were detected. I would also like to know if there is any family history and if you have any incompatibilities and/or a consanguineous marriage.

Now, here are your answers:

1. The serum beta-hCG titres are showing a rising trend and this indicates good progress in pregnancy. Usually, titres double every 2-3 days with a healthy pregnancy.

2. The medication that has been prescribed is the usual protocol followed by any competent obstetrician in a woman with your sort of obstetric history. The medication is meant to cover any possible hormone insufficiency, vascular defects, neural tube defects and hence is preferable. All the medications are safe to be used in pregnancy.

3. Slight cramps can occur as the uterus accommodates the enlarging embryo. The supporting ligaments of the uterus and the surrounding tissues stretch as the uterus enlarges and this can be the cause of the back pain. It is not necessary to have morning sickness, more so since this is not your first pregnancy.

4. The titres of serum beta-hCG vary from individual to individual and hence a wide range is provided for reference. Your titres are within normal limits. In view of your past obstetric history, I would suggest fortnightly visits now.

5. If you had steadily high or rising TSH levels on two occasions done at least two months apart, then you need thyroxine supplementation. This dosage may need to be stepped up in increments as pregnancy advances. Please get further clarification on this from your consultant and see that you rectify if there is any defect. Please remember, thyroid deficiency also can cause abortions.

Finally, please try to avoid stress as much as possible, since anxiety is a major culprit in bad maintenance of a pregnancy. Trust your doctor, everything is going to be fine this time. Avoid strenuous tasks including travel and sexual intercourse.

Hope your query has been clarified. Please feel free to contact for further information. I will be happy to help.

regards,
Shanti.V.

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Brief Answer:
Please repeat the TSH levels 8 weeks from the previous test.

Detailed Answer:
Hi,

Thanks for writing back.

There is no problem with your blood groups.

It would be better if you can repeat the TSH levels 8 weeks after the previous test to see if there is any rise. Are you still on medication?

Hope this helps.

regards,
Shanti.V.

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Brief Answer:
That is fine since you also have the opinion of the endocrinologist.

Detailed Answer:
Hi,

Thanks for writing again.

That is good as the endocrinologist also has opined. Just keep a watch with occasional testing.

Please contact if you need any more help.

Wish you good health.

regards,
Shanti.V.

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