Successful pregnancy after 9 abortions

There is no denial that today, fertility is a challenge that is faced by several couples. Having an abortion is in itself devastating for a couple and then to suffer this again and again can be extremely difficult to deal with and depressing.

Recently, Rainbow Children’s Hospital was successful in bringing happy smiles to the faces of a distraught couple who had the misfortune of suffering 9 abortions due to a unique blood condition called anti phospholipid antibody syndrome (APLA ) positivity. 

What is AntiPhospholipid Antibody Syndrome (APLA) 

This is an unusual condition in which there is a tendency to form blood clots in the blood vessels that supply the pregnancy thereby compromising on the oxygen, nutrition and blood supply going to the pregnancy resulting in poor fetal growth and demise. Initiating anti inflammatory and antithrombotic agents even before she planned her next pregnancy greatly helped achieve our goal.

Journey of the couple with the hospital

Patient, a 32 year old lady, visited the hospital in December last year. She was married for 7 years presented with a history of PCOD and recurrent pregnancy loss. She had 9 previous abortions in the first trimester (less than 8 weeks of pregnancy), as she was APLA positive and had poor outcomes in the past despite taking aspirin and LMWH after the second pregnancy loss.

The lady was given prenatal vitamins and HCQs 2 months before planning pregnancy. Ovulation induction was done and simultaneously ecosprin 75 mg and myoinositol and metformin combination given. She was provided with a good luteal phase support with dydrogesterone 10 mg 3 times a day till 20 weeks of pregnancy, vaginal micronized and injectable progesterone along with LMWH.

The doctor had to stop and restart ecosprin and LMWH several times as she had multiple episodes of bleeding soon after conception, and was even admitted twice to the hospital for heavy bleeding. However it was effectively managed and by 16th week she was on a steady dose of ecosprin 75 and LMWH 40 mg. Subsequent scan at 24 weeks showed small for gestational age baby that was improved through proper diet counselling and regular follow ups. Antenatal steroid prophylaxis for fetal lung maturity was given and LSCS done at 34th week for fetal tachycardia with 3 nuchal loops of cord around the neck and pain abdomen.

With the hospital’s constant efforts and the couple’s determination throughout their journey of these ups and downs, the doctor was able to deliver a healthy male baby of 2.08 kgs on 27/7/23.

Apart from properly evaluating her details, closely monitoring her symptoms and promptly managing her condition without any delays, what helped her a lot was also tele consultation as she had access to immediate medical care without having to travel from home to clinic in emergencies. In addition, educating the patient about emergency medicines that can be taken in such situations greatly helps in mitigating the problems.

It is important to seek professional help in these cases for optimal outcomes. The hospital and the team of doctors feel extremely grateful and blessed for having the opportunity to make a change. It’s moments like these that make their professional endeavours so worthwhile.

Dr. Suman Singh MBBS, MD(OBG), FAM, MCCG Infertility Specialist, Fellowship in Aesthetic Medicine, Masters in Cosmetic Gynaecology, Consultant Obstetrics & Gynecology

Dr. Suman Singh

MBBS, MD(OBG), FAM, MCCG Infertility Specialist, Fellowship in Aesthetic Medicine, Masters in Cosmetic Gynaecology, Consultant Obstetrics & Gynecology

BirthRight By Rainbow Hospitals, Bannerghatta Road, Bengaluru