Hello,

Thanks for posting query. I have gone through your past medical & obstetric history.

According to your height & weight, your Body Mass Index (BMI) is 30.11 and have grade 1 obesity.

I am trying to explain your query as follows:

1) Pain around lower abdomen following miscarriage may be due to intrauterine infection or pelvic inflammatory disease (PID) in co-existence with retained bits of product if any. Obesity is an other factor for occasional lower abdomen pain.
You should undergo one ultrasound scan (USG) to rule out underlying pathology or retained bits if any. In addition, routine and microscopic urine examination is needed to rule out asymptomatic like Spondylosis or spinal osteoarthritis or Cervical radiculopathy or previous trauma around neck.
In this case, one orthopedic consultant can help you much regarding this.

2) Susten is micronised natural progesterone and given to regularize period. It also helps in correction of ovulation time in case of irregular cycle, related to anovulation due to progesterone deficiency.

3) You should continue both thyronorm and obimet medicine if you have poly cystic ovarian disease (PCOD). I think that you have PCOD that's why your doctor prescribed above medicine.
Obimet contains metformin, used in case of hyperinsulinaemia or insulin resistance associated with PCOD and it helps in regularization of ovulation to improve fertility.

You can take calcium supplements along with thyronorm for correction of bony problem or cervical pain.

Before planning next pregnancy, you should undergo several investigation to rule out causes of previous miscarriage like TORCH profile, Blood gr & Rh typing of both (to check Rh incompatibility), Blood sugar (PPBS), Test for chromosomal abnormality, Progesterone level after ovulation etc.

Do following things for life style modification before planning next pregnancy:
1) Control body weight by regular physical exercise in the means of jogging/ walking/ treadmill. It certainly improves fertility and other problem.
2) Avoid stress by yoga/deep breathing regularly 20-30 times at a time.
3) Take healthy diet with avoidance of fatty/ salty food stuff. Also need folic acid, vitamin-E & other supplements.
4) Drink plenty of fluids/water and eat leafy vegetables &fresh fruits.
5) Maintain personal hygiene and need adequate sleeping.
6) Periodic measurement of weight and blood pressure (BP).

Hope I have answered your query. If you have any further questions I will be happy to help.

Wish your good health in future.

Regards,
Dr Soumen

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Hello,

Thanks for follow up query. I am trying to explain your query.

Yes, obesity is one of causative factors for occasional body ache and abdominal pain in co-existence of pelvic infection that cannot be ruled out by ultrasound alone. In this scenario, blood test for TLC/ DC/ ESR and urine examination is helpful.

CMV infection causes defective embryo/fetus in early week of pregnancy and leads to miscarriage. Therefore, it should be treated before planning next pregnancy with your consulting doctor.

Test for blood group and Rhesus type for both of you and your husband is needed to be done to avoid Rh incompatibility. Here, father with positive blood group & mother with negative blood group are more prevalent with concurrent pregnancy loss though first pregnancy is escaped.

Progesterone deficiency is another leading factor for miscarriage. Therefore, Day 21 progesterone assay is advised to check corpus luteum function properly.

If you do not have any clarifications, you can close the discussion and rate the answer.
Take care of yourself.

Regards,
Dr Soumen

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