Patient's Query
Hi doctor,
My wife, who is 23 years old, has autoantibodies SSA strong positive 3+, SSB borderline positive, and RO52 strong positive 3+. She lost her first pregnancy last year, because CHB was found in the fetus by TIFFA at 19 weeks with fetal hydrops and bradycardia. Now, she is eight weeks pregnant.
Our obstetrician planned the treatment as Aspirin 75 mg once daily, Enoxaparin 20 mg daily, Progesterone 200 mg tablet once daily, and Dailyfol. She also planned to start fluorinated steroids from the 12th week and immunoglobulin from the 16th week.
When we went for a second opinion two days back, the fetal medicine specialist found a large subchorionic hemorrhage and advised just to stop Enoxaparin. She advised us to come back again after a month, as it is a high-risk pregnancy. Why did she say so?
Later, we consulted our obstetrician, and she advised us to stop taking Enoxaparin temporarily because it is necessary for controlling antibodies. She advised Duphaston 10 mg twice daily, Xamic 500 mg twice daily in addition to the above, and asked us to have a review after three days.
We need a clear direction now, please answer our questions.
She has morning sickness and back pain from the beginning of pregnancy.
Please advise.
Hi,
Welcome to icliniq.com.
These medications are given to your wife for fetal well-being, and these medications are definitely going to help. Since there is a subchorionic hemorrhage, you have been advised to stop Enoxaparin. She may go a little easy with this medicine and restart it as advised.
Both doctors have given you the same advice, but in a different way. The method of treatment of each doctor may vary, but the mode of treatment will definitely be the same. So, you can follow any advice as both of them mean the same in a different way, though.
Regarding her morning sickness and dullness, they are very common in pregnancy, and you really need not worry about that. They will resolve as the pregnancy progresses. Ask her to start with her calcium supplements, as she is complaining of back pain.
Please do not worry. Things will be taken care of. The only thing is to be a little careful and get your routine antenatal visits done.
I hope this helps.
Thank you, and take care.
Patient's Query
Hi doctor,
Thank you for the reply.
Actually, last time, till the third month, my wife was very well. But in the third month, she used to faint when she stood for a minimum of 10 minutes. But, her gynecologist said there is nothing to worry.
Then, by the fourth month, as the doctor could not hear the fetus' heartbeat easily, she advised a TIFFA scan. This time, I consulted with a gynecologist, whom they recommended in my area. After the termination of pregnancy, my wife was on regular Aspirin 50 mg and Folinol.
Actually, I am worrying more this time, and so I always need a second opinion. Our gynecologist said Xamic 500 is to control bleeding. She also said that at present, there is no bleeding, and it happened once internally.
If so, then why did she prescribe Xamic? Also, the fetal medicine specialist did not prescribe anything. Why?
Please advise.
Hi,
Welcome back to icliniq.com.
I really understand your concern and worry.
With all due respect, I would like to tell you to please relax. I am not telling you not to take care of yourself, but I am asking you to go a little easier. During the fourth month, it isn't easy to find the baby's heartbeat with a stethoscope, and that must be the reason why she took so long to find out the baby's heartbeat.
The fetal medicine doctor will not prescribe you any medications, and she will give only counseling. You are in safe hands, please do not worry.
Get your routine check-up done, and things will definitely be fine.
I hope this helps.
Thank you and take care.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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