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Suggest Treatment During Pregnancy After 3 Miscarriages

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Posted on Mon, 16 Mar 2015
Question: Hi Dr. XXXXXXX

My wife has undergone 3 miscarriages in total, 2 of them were in 2014. She is in her early pregnancy now. Doctor prescribed her endometrin vaginal inserts for progesterone supplement to try and prevent another miscarriage. She has never used vaginal inserts. Can you please let us know if these are safe during pregnancy ? We checked with the doctor if he can prescribe oral progesterone supplement but he said he cannot do that. We are in United States now.

Also, It will be great if you can suggest any other safe ways to prevent another miscarriage.

Thanks and Regards,
XXXX

doctor
Answered by Dr. Dalia Muraleedharan (11 hours later)
Brief Answer:
Continue vaginal progesterone

Detailed Answer:
Hi,
Thanks for writing..
I understand your concern..

Congrats for your pregnancy.. Yes, progesterone vaginal inserts is more effective than oral progesterone.. It supports the pregnancy and has better efficacy.. Progesterone tablets are safe in pregnancy.. Oral tablet containing dydrogesterone is also equally effective.. You can use oral dydrogesterone tablet if you are inconvieneint with vaginal inserts..

As I suggested before, I would suggest to get APLA screening, PT, APTT and ICT if she is negative group.. If APLA screened positive, I would suggest to take aspirin and low molecular weight heparin daily as soon as the cardiac activity appears.. This should be continued till 36 weeks or earlier if she goes in for labour.. This will help to prevent repeated miscarriage to some extent..

Hope I have answered your query.. Feel free to ask any doubts.. Good day..
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Dalia Muraleedharan (12 hours later)
Hi Dr XXXXXXX

I cannot thank you enough for the support you are providing to us. Your support is very valuable to us. Thanks for the guidance !!!

Thanks and Regards,
XXXX
doctor
Answered by Dr. Dalia Muraleedharan (10 minutes later)
Brief Answer:
you are welcome

Detailed Answer:
Hi,
You are welcome..

I'll be happy to help you.. Good day..
Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
Dr.
Dr. Dalia Muraleedharan

OBGYN

Practicing since :2003

Answered : 1044 Questions

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Suggest Treatment During Pregnancy After 3 Miscarriages

Brief Answer: Continue vaginal progesterone Detailed Answer: Hi, Thanks for writing.. I understand your concern.. Congrats for your pregnancy.. Yes, progesterone vaginal inserts is more effective than oral progesterone.. It supports the pregnancy and has better efficacy.. Progesterone tablets are safe in pregnancy.. Oral tablet containing dydrogesterone is also equally effective.. You can use oral dydrogesterone tablet if you are inconvieneint with vaginal inserts.. As I suggested before, I would suggest to get APLA screening, PT, APTT and ICT if she is negative group.. If APLA screened positive, I would suggest to take aspirin and low molecular weight heparin daily as soon as the cardiac activity appears.. This should be continued till 36 weeks or earlier if she goes in for labour.. This will help to prevent repeated miscarriage to some extent.. Hope I have answered your query.. Feel free to ask any doubts.. Good day..