The question
Hi Dr. Sher,
Thank you for taking my question. I am 28 years old who conceived naturally and unfortunately experienced a miscarriage three weeks ago. I was 14 weeks and this was my first pregnancy. Everything I have read online and my OBGYN have all told me that it is very unusual to miscarry in the second trimester. The baby had been doing fine (healthy heartbeat, normal growth) up until the day I began cramping and bleeding so my OB says that she suspects that it could be a placenta abruption or blood clot that caused this but we don't know anything for sure at this stage.
My question is, what do I do from here? Is it a logical next step to consult with a Reproductive Endocrinologist or Reproductive Immunologist at this stage? Would you recommend that I pursue aggressive testing? This was a very traumatic experience for me and I am unsure where to go from here before we start trying again as I would like to minimize the chances of this happening again. Is there still hope?
Thank you for your time
Answer from Dr. Geoffrey Sher
WE should talk!
The commonest causes of mid-trimester miscarriage are:
1. Cervical incompetency
2. Uterine congenital anomaly (e.g. a septum
3. Uterine anatomical pathology (e.g. fibroids; adenomyosis; post surgical scarring; endo-uterine synecheae
4. Placental failure due to vascular or immunologicic causes
5. Developmental fetal abnormalities (genetic and multifactorial)
Geoff Sher
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ADDITIONAL INFORMATION:
I am attaching online links to two E-books which I recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)....... for your reading pleasure:
1.From In Vitro Fertilization to Family: A Journey with Sher Fertility Solutions (SFS) “
http://sherfertilitysolutions.com/sher-fertility-solutions-ebook.pdf
- “Recurrent Pregnancy Loss and Unexplained IVF Failure: The Immunologic Link
https://drive.google.com/file/d/1iYKz-EkAjMqwMa1ZcufIloRdxnAfDH8L/view
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General information only, not medical advice for your own situation. For that, book a consultation.