Readers' Featured Comments/Questions - Why Wait to Conceive after Miscarriage and Rh-negative Concerns
Tuesday, September 04, 2007
Kenneth F. Trofatter, Jr., MD, PhD
I found out from my OB today that I miscarried (I found out I was pregnant on 8/22, and began bleeding on 8/29, he ordered a hCG level test which went from 12 to 2 in a 48 hour period, therefore, confirming a miscarriage). I have had only two other pregnancies, which resulted in two healthy children (now 4 years and 21 months). Anyway he said I had to wait for my next menstrual cyle to start trying to conceive again - why do we have to wait?
To Anonymous Sept 2: I am sorry for your loss. Since you have had other normal pregnancies, the overwhelming odds are that this baby you lost was chromosomally abnormal. You lost this pregnancy so early (very low hCGs) that it probably wouldn't make any difference if you "tried again" during the next cycle. But, I too usually suggest that a woman wait for one normal period before trying again, just to give any 'inflammation' that was associated with the recent loss a chance to resolve to improve the probability of successful implantation the next time around. Waiting also gives your hormones and the endometrium a chance to get back in 'synch' and this too might improve the chances for a successful pregnancy. Thanks for reading and for a good question that, I am sure, is on the mind of many women who are in a similar situation! Best of luck on the next go-around! Dr T
Anonymous has left a new comment on your post "Implications of a "Negative" Blood Type":
I was recently pregnant and miscarried at 6 weeks. Since I am Rh-negative, I was given a shot of Rhogam and was told that it would last in my system for three months. I am pregnant again (5 weeks) and know that the Rhogam is no longer in my system. Will I need another shot ASAP?
To Anonymous Sept 2: Your doctor will perform an antibody screen on you as part of the standard 'new OB' labs early in this new pregnancy. If there is no evidence of sensitization, i.e., you haven't developed any antibodies against Rh-antigen (odds are you were entirely protected from becoming sensitized by having gotten Rhogam with your miscarriage), then you will not get another shot of Rhogam until about 28 weeks, unless you have an indication such as bleeding, trauma, or an amniocentesis with this pregnancy before then. Best wishes this time around and thank you for reading! Dr T
Anonymous has left a new comment on your post "Implications of a "Negative" Blood Type":
Hello! I am A- and my husband is O+. Will we have problems conceiving or problems during the pregnancy because of our different blood types?
To Anonymous Sept 3: Your different blood types should not increase difficulty conceiving. Because you are Rh-negative and your husband is Rh-positive, you are at a small risk of becoming 'sensitized' to the Rh-antigen during a pregnancy (if the baby is Rh-positive like your husband) or at the time of delivery. However, getting Rhogam (which contains anti-Rh antibody) during and after the pregnancy greatly reduces the chance of isoimmunization because it helps your body get rid of any fetal blood cells that have gotten into your circulation before your own body makes antibodies to them. In fact, it may actually suppress your immune system from making Rh-specific antibodies! I certainly wouldn't sweat the issue at this point! Go out (or stay in) and get pregnant and don't fret about this. Thanks for reading! Dr T
Labels: blood types and pregnancy complications, early miscarriage, Rh-isoimmunization
4 Comments:
At Thu Sep 06, 02:11:00 PM 2007,
Anonymous said…
If the Mother is ab positive and the father is ? neg is there any problems with those matches or is the problem only if the mother is neg and the father positive? Thank you
At Sun Sep 09, 06:27:00 PM 2007,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Anonymous Sept 6: With those blood types, there should be very little risk of Rh-isoimmunization. Our major concern is if the MOTHER is Rh-negative and the father is Rh-positive. Thanks for reading! Dr T
At Mon Sep 17, 02:07:00 PM 2007,
Anonymous said…
Dr-
i just had my third miscarriage and the first one, i didn't have tested, the second one was a partial mole pregnancy and after the waiting period was over, i got pregnant for the third time. I lost the baby in week 6 and test just came back where the fetus had 47 chromosomes. my dr thinks it's a fluke and that my husband and i just had bad luck. do you suggest trying again or do you think i have a chromosome condition?
At Thu Sep 20, 04:44:00 PM 2007,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Anonymous Sept 17: From what you describe, I would have to agree with your doctor at this point. You have probably just had a string of bad luck. The first pregnancy could have been lost either because it simply was a first pregnancy and your immune system didn't figure out how to help it hang on or that baby could have had a chromosomal abnormality. The last two pregnancies were clearly chromosomally abnormal, but they were also different abnormalities. If you are anxious enough, consider having chromosomal studies done on you and your husband. - but, I bet now they will be normal. There may be some individuals who are at increased risk for aneuploidy that we don't thoroughly understand. Some genetic counselors will tell you that having a documented aneuploid pregnancy increases your risk to as much as 1% that you will have another. You did not tell me your age, but if you are less than 38, this is higher than your age alone risk. I would recommend to anyone who has had chromosomally abnormal pregnancies that they seriously consider having combined first trimester screening for aneuploidy, regardless of their age. Thank you for reading and I certainly wish you better luck in the future. Dr T.
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