home *** CD-ROM | disk | FTP | other *** search
- Path: senator-bedfellow.mit.edu!dreaderd!not-for-mail
- Message-ID: <misc-kids/miscarriage/part2_1082200966@rtfm.mit.edu>
- Supersedes: <misc-kids/miscarriage/part2_1079601013@rtfm.mit.edu>
- Expires: 31 May 2004 11:22:46 GMT
- References: <misc-kids/miscarriage/part1_1082200966@rtfm.mit.edu>
- X-Last-Updated: 1997/03/16
- Organization: none
- Approved: news-answers-request@mit.edu,kids-info-request@ai.mit.edu
- From: brook006@mc.duke.edu
- Newsgroups: misc.kids.info,soc.support.pregnancy.loss,misc.answers,soc.answers,news.answers
- Subject: misc.kids FAQ on Miscarriage, Part 2/3
- Followup-To: misc.kids
- Summary: The miscarriage FAQ is a compilation of people's
- experiences, words of sympathy, and some technical
- information.
- Originator: faqserv@penguin-lust.MIT.EDU
- Date: 17 Apr 2004 11:26:29 GMT
- Lines: 600
- NNTP-Posting-Host: penguin-lust.mit.edu
- X-Trace: 1082201189 senator-bedfellow.mit.edu 576 18.181.0.29
- Xref: senator-bedfellow.mit.edu misc.kids.info:6244 soc.support.pregnancy.loss:17992 misc.answers:17194 soc.answers:19004 news.answers:269739
-
- Archive-name: misc-kids/miscarriage/part2
- Posting-Frequency: monthly
-
- Misc.kids Frequently Asked Questions
- Miscarriage
-
- Part 2 of 3
-
- ---------------------------------------------------------------------------
- Causes and Technical Information (cont.)
- ---------------------------------------------------------------------------
- I read your post to misc.kids about having 2 miscarriages in a row, and
- really feel for you. Unfortunately, I had 3 miscarriages in a row (after
- having a previous normal pregnancy, which made it all the more puzzling). I
- will be glad to share my experiences with you, but I want to relate a some
- things first: You said you realized there is not always a reason. Not true!
- I said the same thing, and our doctor (a specialist in recurrent
- miscarriages) said there is always a reason, the problem comes in finding
- the reason. Also, it may be helpful for you to contact RESOLVE. RESOLVE is
- a support/education/advocacy group for infertile couples. I'm not saying
- you are infertile, but someone like me (after 3 in a row, I am considered
- infertile - unable to carry a pregancy to term) is. They have lots of good
- information on miscarriages, and there are lots of opportunities to get in
- contact with people you have or are going through similar experiences. I
- don't have their phone number with me right now, but will get it to you if
- you want it.
-
- Now to our situation. We have a little boy who will be 4 at the end of May.
- I got pregnant in April of 1992, and everything seemed to be going fine.
- The ultrasound we had at the time of the amnio showed a beautiful, normal
- miniature baby. Then, inexplicability, the baby died in utero. I began to
- get nervous after a while, because a friend at work was pregnant at the
- same time (we were due 2 weeks apart), and she was feeling lots of
- movement. I was actually standing in front of the mirror in the mornings,
- looking at my breasts, asking myself - "Are they getting smaller?" I didn't
- say anything to anyone, thinking I was exhibiting hysterical pregnancy
- fears. Well, the water broke at 19 weeks, and I aborted. Thankfully we got
- to the hospital in time, and it happened there. The pathology showed
- nothing abnormal, and all my OB could tell me was a guess - a cord
- accident. A rare, random event. That reasured us somewhat, so we tried
- again. We lost that pregnancy at about 8 weeks, and lost the third at 10
- weeks (that was May of 1993). Well, by that time we said "Enough is
- enough!" and we found an excellent doctor in Boston who specializes in
- recurrent miscarriages. My mother in law sent me a newspaper article after
- the second miscarriage in which the reporter interviewed this particular
- doctor. I hauled it out and read it after the 3rd loss, and that gave us a
- name. I then talked to people at RESOLVE, and he was highly spoken of. He
- is Dr. Joseph Hill, a reproductive endocrinologist at Brigham and Womens
- Hospital.
-
- Here is a description of the tests he ordered for us:
-
- 1. Chromosomal analysis of my husband and myself. He said that a
- chromosomal abnormality in one or both of us could result in recurrent
- losses, but that this was not too common. This involved drawing a blood
- sample from both of us. Everything was normal.
-
- 2. Endometrial biopsy. This involved removing a sample of the lining of the
- uterus just before my period started. The development of the lining was
- assessed to determine if I had a leutal phase defect (ie levels of hormones
- not right to support a pregancy). By the way - I am not a medical person,
- and do not have my reference materials with me as I write this, so my
- explanations my be off somewhat! This was uncomfortable, but not overly so.
- Some women feel more discomfort than I did. I believe they told me to take
- motrin before the procedure to minimize discomfort. This was normal.
-
- 3. Hysterosalpinogram (spelling?) also called a 'Tubogram' - during this
- procedure, a dye is injected into the uterus, and the radiologist takes
- photos to assess the condition of the fallopian tubes (open, closed) and
- the uterus. Abnormalitites in the shape of the uterus can cause recurrent
- miscarriages. This was normal. Some women have quite a bit of discomfort
- with this, but it was not too bad for me. They had me take antibiotics
- prior to and after the test. This was done to prevent infection.
-
- 4. Blood tests for anticardiolipid antibodies and lupus anticougulant
- antibodies. This was also normal!
-
- Tests 1-4 are the standard tests that are performed during an assessment of
- recurrent miscarriages. During our initial visit, Dr. Hill said that a
- large proportion of couples are not diagnosed by these tests. He then
- proceeded to say that he has developed a theory of recurrent pregnancy
- loss, in which the women's body views the early placental tissue and/or the
- early fetal tissue as foreign objects. The white blood cells then attack
- and cause a miscarriage. He has developed a blood test that detects what he
- calls 'embryotoxic factors'. It is my understanding that these 'embryotoxic
- factors' are proteins given off as part of the process of attack by the
- white blood cells. Please remember my previous disclaimer! He said that of
- the couples who test negative during the standard tests, 80% test positive
- for the embryotoxic factors. Well, I tested postive for the embryotoxic
- factors, followed his treatment, and am now beginning the third trimester
- of a healthy, normal pregnancy. I will be glad to send you details of the
- treatment, but it is basically rather high doses of progesterone during the
- first 20 weeks of pregnancy. There is no danger to the fetus. Doctor Hill
- said that physcians have been prescribing progesterone for recurrent
- miscarrianges for years, without really knowing if it would work. The
- thinking was that it couldn't hurt. Well, they may have been treating this
- condition without realizing it.
-
- We naturally asked him about our normal first pregnancy, and the fetal
- demise. His theory on this is that when the baby died and stayed in the
- uterus (for as long as 2 weeks, maybe) that my body became sensitized to
- pregnancies and attacked the subsequent two. He said a normal pregnancy
- changes the women's immune system to keep itself from being attacked as a
- foreign object (which it is, being composed of half your partner's genes).
-
- Doctor Hill said his treatment has not had the benefit of a double - blind,
- placebo controlled study because he has not been able to get the funding
- for such a study. He does believe there is "something to it", though. The
- women at RESOLVE said he has a high success rate, and that 4 or 5 years
- ago, when he was just getting started with this, that his waiting room
- would be clogged with frantic women looking for help. He has modified his
- office procedures a lot since then, and the situation is busy, but much
- more orderly. Another empirical verification came from a doctor at the same
- hospital who is using a special ultrasound technique to study blood flow
- around the fetus and placenta of women who suffer recurrent losses. Her
- subjects come from Dr. Hill, and are under his treatment, and she said a
- problem (for her, not for me) is that there are very few failures
- (miscarriages) so she doesn't have much data! That was reassuring.
-
- I don't know how much reading you have done on the subject of recurrent
- miscarriages, but a recent theory says that the woman and man can be too
- close to each other genetically, and that some sort of injection into the
- woman can help (I don't know too much about this theory). Anyway, Dr. Hill
- said that has recently been debunked. This theory was promoted by a doctor
- in Philadelphia.
-
- Another thing - Dr. Hill has said that if a couple is in their 30's and has
- had 2 miscarriages that they should consider having a workup. I don't know
- your situation, but it is something to keep in mind.
-
- Yet something else - Don't hesitate to go to a specialist! You may like
- your OB/GYN just fine (like I do), but don't feel you are being disloyal by
- going to a specialist. After the 3rd loss, by OB/GYN said "I can't help you
- with this". So off we went, and are we glad!
-
- Please pursue this with as much vigor as you can muster, and don't give up
- hope! I have just dealt with the medical aspects of my experience here, not
- the emotional. Please let me know if you care to exchange notes on the
- latter. Best of luck and let me know how you are doing!
- ---------------------------------------------------------------------------
- Got your message. I'm glad you are seeing a doctor who wants to start
- testing soon. The tests on me took 1 cycle to complete, which was much
- faster than I had thought. I should think that your body has to readjust a
- bit before the more invasive procedures are done, though.
-
- In the newspaper article on Dr. Hill, he said progesterone was described in
- the '70's as 'nature's immune supressor', and that is why they looked at it
- as a possible treatment for this condition. We asked him why he chose the
- dosage he did (50 mg progesterone twice a day via vaginal suppositories
- (ugh)). He said that in the lab they added progesterone equivalant to that
- dosage to the blood of women who tested positive for the toxic factors, and
- they (the factors) disappeared. He said there is no guarantee that the
- levels of progesterone in the women's blood would be the same, however,
- because each women's body is different. He said if the woman miscarries
- under his treatment they increase the dose of progesterone in hopes that
- will deactivate the toxic factors.
-
- The blood test he uses is, to my knowledge, different from the usual tests
- for antibodies (I *think* the usual tests are for the anticardiolipid and
- lupus anticougulant antibodies - may want to ask your doctor on this). I
- think he is the only person doing this test, and do not know if he does it
- 'long distance'. Dr. Hill and another doctor co-authored a chapter of a
- book, and it deals with miscarriages (causes, treatments). He gave us a
- copy to read, and I his theory is described there. I'll try to get the
- reference for you (and your doctor?) if you want.
- ---------------------------------------------------------------------------
- Here is the information on the book:
-
- Kistner's Textbook of Gynecology. 1990.
-
- It will be updated this year. Hill's secretary got the information for me,
- and when I asked her if she had the publisher, she just laughed. I guess
- she considered herself lucky to get that information from him (he's busy!).
-
- It has been good to correspond with you. Please keep me updated on how you
- are doing, and how the results of the tests come out. You are doing the
- right thing by being an active participant, because you and your partner
- have the most to gain and the most to lose.
- ---------------------------------------------------------------------------
- Dreams and Realities
- by Nancy P. Hemenway
-
- Reflecting back on a hot morning in early August, I distinctly remember the
- eager anticipation of the long awaited culmination of my hopes and dreams
- in my marriage to David. I was 38 and I had kissed a lot of frogs before my
- prince came along. Hearing the loud ticking of the biological clock was
- enough to throw caution to wind (along with our birth control) a whole 2
- months into our marriage! My only concern at this point was that I might
- get pregnant too fast and our "honeymoon" would be cut short! When nothing
- happened the first year I became concerned but realizing we were both
- healthy, active individuals, I pushed that thought as far away as possible
- attributing it to works schedules and bad timing. Another two birthdays and
- no pregnancy.
-
- Then in July while on vacation in Florida I realized my period was late.
- David and I rushed to a local drug store for our first of many home
- pregnancy tests. Postive! ! I couldn't believe it! We were finally going to
- have a baby. Unfortuanately, we were both a little naive and innocent about
- pregnancy. At about 7 weeks I started spotting so we rushed to the Dr. and
- had an ultrasound. The results were alright and everything looked fine. He
- told us 20% of pregnant woman bleed. The spotting continued and the
- cramping began. The next sono revealed a problem with the sac and the
- doctor told us I was "threatening a miscarriage". My heart was in my knees
- but I managed to pull myself together and push these negative thoughts out
- of my head. At almost 10 weeks we had another ultrasound. The doctor told
- us the baby was growing again and the sac looked ok. We lost the baby the
- next day in the hospital emergency room. Having come from a background in
- nursing, I asked for genetic testing of the fetus. I was told because it
- was only my first pregnancy they would not do this. I also believe they
- attributed the loss to my age (41). The genetic testing I never had could
- have been a major diagnostic link with the problems we have now been
- diagnosed as having.
-
- Several months after my first miscarriage I referred myself to a
- reproductive endocrinologist who tested both of us for every disease know
- to man (and woman). Over the next two years, we went through ovulation
- induction with all the drugs, had numerous IUI's (intrauterine
- insemination) and finally three cycles of IVF. We were again, overjoyed,
- when I got pregnant on the second cycle. This pregnancy ended at about 6
- weeks.
-
- The Quest For a Diagnosis
-
- Through all the testing I never had a diagnosis. The doctors never found
- anything wrong with either my husband or me. "Unexplained Infertility",
- that's what they call us. We're healthy, active people, "the perfect
- couple" except we can't do what 90% of the rest of the couples can do. I am
- not the kind of person to settle for "unexplained", so I set out on my own
- personal quest to, at least, explain why I couldn't get pregnant or stay
- that way once I achieved a pregnancy. I searched the internet for articles
- and read everything I could on infertility. I commiserated with my
- "sisterhood of infertility" on the medical support bulletin board of
- Prodigy. One of the women on the bulletin board had a similar history to us
- and sent me some research studies. I couldn't believe what I was reading.
- Dr. Alan Beer of the Chicago Medical School in North Chicago Illinois had
- been studying the immune system as it relates to reproduction for about 20
- years. I read about women (just like me) in many parts of the studies. I
- gathered up the information and took it to my doctor. He told me this was
- rare and he didn't think I had these problems. I decided to refer myself to
- Dr. Beer.
-
- After a review of my chart, he told us we were indeed candidates for
- problems in this area and ordered blood tests to be done. Not only did we
- have these problems but Dr. Beer told us they were about as "bad as he
- knows they can get!" My new diagnosis was : Habitual Aborter. Dr. Beer had
- discovered we have three major problem areas: Blocking Factor Problem,
- Antiphospholipid Antibodies, and Natural Killer Cells.
-
- Blocking Antibodies
-
- One out of every 200 - 300 couples who marry and start a family will share
- similar tissue types to their spouse. Basically this is a white blood cell
- (WBC) problem. In the WBC system symbols relate to different types of
- cells. The last 4 symbols are called the DR / DQ numbers . these DR/DQ
- numbers are inherited . Couples who lose every pregnancy are matched for 3
- out of 4 of these number (symbols). David and I found out that we are an
- "unlucky match". Our DR / DQ numbers are 1.1, 1.2, 1.3 and a 4 . There is
- little more than one amino acid's difference between us. This means we are
- 75% alike.
-
- As you know the WBC system is our defense against disease. Each of the
- above numbers within the WBC system have little antennae which when touched
- by a certain virus or bacteria sends signals to make antibodies. These
- antibodies take care of any foreign interlopers (bacteria) entering the
- body. The man has all the genes (in his sperm) to blueprint out the
- placenta. He starts to build the placenta . This sends a message from
- outside of the woman's body (from the genes within the sperm) to alert the
- mother's body to prepare for a baby. The message sent from the man is
- called "g". All the cells of the placenta that line up around the egg have
- the genes that will be needed to construct the placenta and the message
- sent is also "g". The mom and dad are now in a partnership together
- building the placenta. The dad's "g" should be different from the mom's
- "g". The mom is responsible for making antibodies to dad's "g". This will
- provide a camoflage for the baby making it a sort of "wolf in sheep's
- clothing". The "g" of the husband acts liks a fertilizer, a growth molecule
- telling the placenta to grow and divide. When a couple is similar (as we
- are) there are too few antibodies to "cloak" the fetus. The placenta
- doesn't grow and divide like it should, beta tests don't double,
- ultrasounds may be "up and down" , the sac may disappear and the pregnancy
- is pretty much doomed.
-
- There is hope for this problem. Dr. Beer extracts the WBC from the husband
- (or a donor if the couple is too similar). The lab takes the WBCs and feeds
- them wheatgerm . After a couple of hours of breakfast the cells grow and
- divide. Dr. Beer theorizes at this point the "g" comes out of hiding. A
- concentrated serum is made (10,000 times stronger than what would be found
- in the placenta) and it is injected under the skin of the forearm (of the
- wife) much like a skin test for allergies. After two lymphocyte
- immuniztions (two sets of injections) the couple ought to be capable of
- producing the blocking antibodies necessary to take the pregnancy to term.
-
- Antiphospholipid Antibodies
-
- There are consequences for every action. Pregnancy is no different. Each
- time a pregnancy doesn't make it inside your body, there are conseguences.
- This includes even the act of fertilizing an egg. A 20% chance exists with
- each pregnancy and/or pregnancy loss that one problem make create another.
- In all probability, this is why we now have the antiphospholipid antibody
- problem. The phospholipids are a sort of glue necessary in every pregnancy.
- They look like little snowfalkes (of fat) which have a sticky end to hold
- the cells together. They fuse into other cells and act like a membrane .
- Think of them like a swimming pool filter. The phospholipids filter the
- nourishment from your blood and than in turn filter the baby's waste back
- through the placenta which feeds the baby and produces the BHCG throughout
- pregnancy.
-
- Phosphlioids necessary in pregnancy are: cardiolipin, ethanolamine,
- phosphatidic acid, glycerol and serine . In our particular case I have
- developed an immunity to ethanolamine (this is the "glue" which also sticks
- the sperm to the egg). Just like being immune to chicken pox and measles (I
- no longer get them) I now am immune ethanolamine so I no longer get
- pregnant. Ethanolamine and serine are also the "glues" which are necessary
- to build the placenta, so even if I were to get pregnant I still wouldn't
- be capable of building the placenta. Couples with this problem are good
- candidates for multiple failures at IVF / GIFT / ZIFT cycles. Once you have
- developed an immunity to one of the phospholipids there will be an attack
- on the baby even in a donor cycle! This problem is 97% efficient in the end
- to a pregnancy.
-
- However the key which locks this glue in place is your own body's natural
- heparin. Most people think of heparin as a blood thinner but in the case of
- combating the phospholipids, heparin acts in a way to lock the glue in
- place and keep the organs attached. The heparin must be taken preconception
- because the cells are already functioning as they are lining up around the
- egg. If there is a pregnancy 86% of the woman will become mothers. If they
- wait until after a postive pregnancy test 75% will lose their babies again.
- After the immunizations, treatment with heparin and baby asprin
- preconception 30% of Dr. Beer's patients have been successful without the
- use of ART.
-
- Natural Killer Cells and "Unexplained Infertility"
-
- It seems like years since we sat in Dr. Beer's office on a very cold, snowy
- Chicago morning in December. The consultation lasted almost two hours and
- Dr. Beer saved the "best" until last. The problem with my natural killer
- cells was the "icing on the cake" and probably the most difficult thing for
- me (us) to deal with. Everyone has (circulating) in their body something
- called natural killer cells. They secrete a substance called TNF (tumor
- necrosis factor) and lately the "powers that be" have been looking at the
- body's own immune system (these NK cells) as a way to fight cancer. The
- overactivity of these cells producing their TNF is deadly to a pregnancy.
-
- Unfortunately for us, I have an overactive immune system. Remember the DR
- /DQ numbers? I inherited a "4" from my father which puts me on the "Olympic
- Team of Immune Responses". Unless we can get this problem under control
- ther may be no way to complete a pregnancy. Treatment involves infusions of
- IVIG (intravenous immunoglobulin). The drug is called Gammamune and it is
- administered through an IV over a period of three days each month
- (preconception). Dr. Beer arranges to have this given through a home health
- care agency. the latest studies concerning this treatment are more than
- encouraging. Woman who have unexplained infertility are able to conceive
- with this treatment. Preliminary studies in recent clinical trials are
- showing as high as 80% are able to conceive with the use of IVIG.
-
- Light at the End of the Tunnel
-
- Our consultation with Dr. Alan Beer although hard, was a breath of fresh
- air. Dr. Beer with his impecable credentials and extensive knowledge of
- immunology exudes compassion for his patients . For many of us this is our
- last stop. Dr. Beer did both his residency and Genetics and a fellowship in
- Obstetrics and Gynocology at the University of Pennsylvania. He is a board
- certified OB/GYN who is also a joint Professor in the Department of
- Obstetrics and Gynocology and Microbiology and Immunology at the Chicago
- Medical School. Dr. Beer has been researching the issues associated with
- the question of why a mother does not reject the newly formed child in
- utero since 1970. I hope David and I will have a "Beer Baby" but whatever
- happens I will forever be grateful to Dr. Alan Beer and his dedicated staff
- for turning on that light at the end of the tunnel. For there truely is
- hope now that didn't exsist before.
-
- Addendum:
-
- Dr. Beer started treating us in November of 1993. We went back to IUI and
- then again to IVF. We were again successful on our FET (frozen embryo
- transfer) but this time the pregnancy is well underway. At this writing I
- am almost 26 weeks pregnant. We are due August 13, 1995. Our little "Beer
- Baby" is indeed on the way and that light at the end of the tunnel is very
- bright indeed now!
-
- Nancy P. Hemenway inciid@mnsinc.com
- ---------------------------------------------------------------------------
- It has been my experience that the miscarriage process has not been
- adequately covered by books or by doctors, especially, the emotional
- distress afterwards. Besides the understandable grieving process, I think
- that there is also a hormonal aspect that has caused me to experience "PMS
- times 10" for a month after each miscarriage. I had never had a PMS problem
- before I had the miscarriages, so I was not prepared for the emotional
- rollercoaster that followed. While some of it was natural mourning, and
- therefore a process that is necessary, even spiritually beneficial, to
- undergo, some of it was simply distressing and non-productive. I am
- starting to research literature on reducing PMS symptoms to see if it would
- also reduce the post-miscarrage syndrome.
-
- While I have not found much on herbal or vitamin recommendations for post
- miscarriage there are several for the traditional PMS. The whole B complex
- - especially B-6 has been shown to be useful for alleviating symptoms.
- Folic acid is also recommended. Supposedly, one of the reasons for the
- chocolate cravings that occur with PMS is a need for magnesium, which
- should be taken with calcium. I don't even like chocolate that much but I
- found myself wolfing down candy bars after each miscarriage. Herbal
- treatments include: St. John's Wort for depression, Valerian for anxiety
- and Dong Quai (there are numerous spellings) for disorientation.
-
- From the readings, I gather that Valerian should only be taken before
- bedtime, but the other two can be taken during the day. In fact, St.John's
- Wort not only has an immediate soothing effect, but supposedly has some
- enzyme-like positive effects that can only be felt after a few months of
- usage. Please research these before taking there are some medications that
- can't be taken with St. John's Wort, like asthma medicine. I took it during
- my pregnancy, along with Skullcap, to help sleep. There is a book that
- mentions these herbs called "Relief from PMS" by Pamela Patrick Novotory,
- published by Dell. I hope this helps.
-
- Deborah Pastor DAnnPastor@aol.com
-
- ---------------------------------------------------------------------------
- Bleeding in Pregnancy
- ---------------------------------------------------------------------------
-
- The question came up about bleeding during pregnancy and whether or not
- that indicates miscarriage. The summary of what I have to say is that I
- have been told that more than half of the women who bleed during pregnancy
- go on to deliver a full-term child, but pay attention and don't take it
- lightly if you find yourself bleeding.
-
- When I miscarried, I spotted for three days, lost the baby, and then
- continued to bleed for another week. I read like mad before I lost the
- baby, so I found all sorts of information. The three best books I had were
- "The Well Pregnancy Book," "A midwifes Guide to Pregnancy and Childbirth,"
- and "Preventing Miscarriage: the Good News." I also talked to about 5
- doctors in the course of being given 2 ultrasounds and some phone advice in
- the face of various changes. Things I learned (this is graphic):
-
- All vaginal bleeding *OF*ANY*KIND* should immediately be reported to your
- doctor. Don't wait until lunch, don't wait until morning, don't wait to
- make the drive: call and report what you can to whoever is in a position to
- advise you.
-
- Heavy bleeding is more likely to indicate miscarriage than spotting, but
- even women who bleed heavily do carry to term. One book said some women
- shed the uterine lining that is not near the embryo's implantation site.
-
- Bleeding accompanied by cramping or any kind of abdominal pain is more
- likely to indicate miscarriage. It is also an indicator for an ectopic
- pregnancy--especially if the pain is more on one side than the other.
- (Ectopic pregnancies will lose you a fallopian tube if you don't catch them
- *very* early.) Don't panic if you do have cramps, because digestive
- distress and stretching of uterine ligaments can cause abdominal pain too.
-
- Bright red blood is much more likely to indicate miscarriage than dark
- brown blood. Anything gray or pink is a very, very bad sign, since it
- usually indicates embryonic tissue or placenta. In my case, the fetal sack
- itself was unmistakable and left me no room for doubt (or hope).
-
- Bleeding that continues for three days or more is more likely to indicate
- miscarriage than some spotting that stops.
-
- Bleeding that occurs when you would have had your period is much less
- worrisome than bleeding that occurs during what would have been mid-cycle.
- Implantation bleeding is *very*common*, and it occurs around when your
- first period would have been. Many women will have bleeding at their normal
- menstrual points for up to three months.
-
- If you have a fever, faintness, or nausea markedly worse than it has been
- until you started bleeding (especially if it is accompanied by worsening
- abdominal pain), you may have an ectopic pregnancy that needs emergency
- treatment: don't wait to make that call--you need to receive further
- instructions based on your case.
-
- Two of my books told me that women who bleed and can get an ultrasound
- should be totally reassured once they see a strong regular fetal heartbeat.
- One book told me that 90% of the women who are bleeding but have a fetal
- heartbeat shown with ultrasound will carry to term. You have to be careful
- though, because those statistics are for abdominal probe ultrasounds, and
- apparently seeing a heartbeat using the trans-vaginal probe is not so
- reassuring. (I only found that last out because I lost my baby after seeing
- a strong heartbeat on the ultrasound monitor.) So I guess the amended rule
- is that if you are far enough along to see the heartbeat with an abdominal
- probe (and you see the heartbeat), stop worrying.
-
- The last, and most depressing thing I have to say is that if you do start
- losing anything gray or pink (or anything solid), you need to save it and
- give it to your doctor. What you lost can tell them if you have miscarried,
- if you might need a D&C to make sure no tissue is left behind, and (in very
- rare cases) clues to the cause of the miscarriage. Mostly, you will never
- know what caused it, but if you are like me, you have a tremendous need to
- try to find out how this happened.
-
- In my case, the fetal sack was a good clue because it was much too small
- for my stage of pregnancy. Even though I had a baby with a beating heart,
- something was wrong. Two doctors suggested that even though the
- cardiovascular system of my little one was showing signs of working well,
- the baby was not getting enough in the way of nutrients. They suggested
- that it might be an implantation problem. This is all conjecture, but even
- having a plausible scenario helped me. I needed an explanation of how I
- managed to violate the maxim about no longer worrying about the bleeding
- once you see the heartbeat.
-
- Tracy Larrabee larrabee@cse.ucsc.edu
- ---------------------------------------------------------------------------
- Tracy, thank you for a very informative article on bleeding in pregnancy,
- however, I would like to point out one thing about the statistic above. The
- fact that over 50% of women who bleed during pregnancy go on to deliver a
- full-term child doesn't mean (and you didn't imply this, either, but I'm
- sure someone will read this this way) that if you do bleed you have a 50%
- chance of miscarriage.
-
- I am currently 24 weeks pregnant with my second child, and with both
- pregnancies I bled and had cramps at the beginning. The first one was worse
- and I spent three months thinking a miscarriage was imminent. I had
- intermittent, heavy, bright red bleeding accompanied by sometimes severe
- cramps. Fortunately, everything turned out fine, and I delivered a big
- healthy baby boy. If I had read this article during those first three
- months, however, I would have freaked out.
-
- Anyway, maybe you could add a note to your FAQ article pointing out that
- every pregnancy is different and that although bleeding is a signal that
- you should get checked by the doctor, it doesn't necessarily mean
- miscarriage is likely, or even indicate a 50% chance of miscarriage for any
- particular woman.
-
- BTW, in my case it turned out that I wasn't bleeding from the uterus after
- all, but that I have what they call a "friable cervix," which means that it
- has a lot of blood vessels in it that bleed easily. So despite all my
- worrying, I probably wasn't in any more danger of miscarriage than in any
- non-bleeding first-trimester pregnancy.
-
- Anyway, this is just my experience.
-
- Thanks,
-
- Judy Drake judy@pendragon.cna.tek.com
- ---------------------------------------------------------------------------
- I first want to preface this by telling you that I had a perfectly healthy
- baby boy - 8 lbs 11 oz, 23 1/2 " long! At 7 weeks, before my first Dr.'s
- visit, I had spotting of the dark brown kind. This was over the weekend, so
- the Dr. told me to schedule an ultrasound on monday morning to see if
- everything looked normal. The baby's heartbeat and growth all looked
- perfectly normal, so he said I could continue all regular exercise. Don't
- take up a new sport, but he specifically said my horseback riding was
- perfectly fine, just no jumping. At 10 weeks, I tried out a friend's horse
- for only 10-15 minutes, but when I got off the horse, I had floods of blood
- running down my legs. I was hysterical, and my friend rushed me to the
- emergency room. I assumed I had miscarried because I couldn't believe there
- could be so much blood and the baby could live. They called in an
- ultrasound tech, and the ultrasound showed a healthy baby with a normal
- heartbeat. 10 weeks is before the placenta is completely formed, but they
- guessed that I had a low lying placenta and had torn off a piece of it. I
- was given strict orders for bedrest for a week, but before the week was
- out, I had hemorrhaged again. This heavy bleeding continued off and on
- until 14 weeks even with bedrest. For no apparent reason, I would stand up
- and the floods would just start. It went away on its own. Later sonograms
- confirmed that I had a small piece of placenta that had torn off. They
- explained that the danger passed because as I got bigger, the placenta
- moved up with my expanding uterus. At the time, all they could tell me as a
- diagnosis was "threatening to miscarry". Any unexplained vaginal bleeding
- during a pregnancy gets this label. I carried my pregnancy to term, but the
- next time I am pregnant, I will not ride a horse regardless of what the Dr.
- says!
-
- Michelle Schott MBS4@psuvm.psu.edu
- ---------------------------------------------------------------------------
- I think when you start to bleed in the first trimester, this is not good,
- but not always bad. My doctor had me check the color (bright red is bad),
- as well as the amount of bleeding. I was in my 8th week when I started to
- spot.
-
- My doctor told me that if bed rest doesnt slow down my bleeding they would
- have me take a quanitative pregnancy test. The test showed that my HCG
- level was down very low and this is why I was bleeding and if it continued
- to drop that meant that I was miscarrying. I miscarried after 1 1/2 days of
- bed rest. I got pregnant 4 months later and gave birth to a healthy baby
- boy in May. I feel that my first pregnancy that ended in miscarraige was
- not meant to be. It took some time to get over, but I did. I do think about
- it, I did all through my second pregnancy, and I thank God for giving me
- Zachary.
-
- I think its important that women who are pregnant be aware of what may or
- may not happen. I went into my first pregnancy thinking that every thing
- would be perfect, I had no worries, then boom it happened. With my second
- pregnancy I knew what could happen, so I took it one step at a time. I
- didnt tell anyone until I was well into my third month. Then when I started
- to show and I heard the baby's heartbeat I just sat back and enjoyed being
- pregnant.
- ---------------------------------------------------------------------------
- I had spotting with both my pregnancies (one ended with a lovely girl, the
- other was a miscarriage at around 6 weeks) and the only difference I could
- see was that the spotting was a little heavier for the one that miscarried.
- So spotting may not be a definite indicator of an impending miscarriage.
-
- I also disagree with the doctor who said to keep on with normal activities
- even with the spotting. My doctor recommended taking it easy the first
- trimester (the spotting ended after that) because that's the time when you
- are most likely to miscarry and a little extra care (no heavy lifting, no
- athletic exercise beyond walking, etc.) would go a long way to prevent any
- sad endings.
-
- Joanne Petersen joanne@hpcc01.corp.hp.com
- ---------------------------------------------------------------------------
-
-