What Is The Cause For The Miscarriages From The Reports?

Good Morning Doctor,
My wife have three miscarriage. we are upset now. I am sending you all details of all pregnancy. Please help me and advice me. Detail are given below:-

Name -           Madhumita Das
Age-               29
Husband Name-     Sanjeev Kumar
Age-               38
Marriage-           03-06-2009

First Pregnancy (LMP 19.02.2010)
Positive pregnancy test on 24.03.2010 by home test kit.

First gynecologist visit on 02.04.2010 (42th day from LMP)
Gynecologist Name- Sakuntala Kumar
Doctor examine vaginally with TVS. Suspect about late period (answer –no).
She prescribed medicine-
Folinext- one daily
Lupigest 200mg- one daily.

Spotting on 04.04.2010 evening( 44th day from LMP. i.e 2 day after medicine start).
Call doctor, she advice insert lupigest vaginally, take rest and consult in morning.
I consult doctor next day. She examines with TVS and prescribed medicine-

Folinext- one daily
Lupigest 200mg(vaginally) -twice daily.
Duphastone(10mg)- -twice daily.
Ecosprine-one daily.

Advice TVS after one week for viability.

First Ultrasound (vaginally) done by radiologist on 13.04.2010 (53th day from LMP)
Show single intrauterine gestational sac with fetal pole and yolk sac.
CRL is 0.44 cm-----6 week 1 day ( 1 week 3day less corresponding from LMP)
Cardiac activity present.
Impression;- Single viable Intrauterine pregnancy.

Doctor advised repeat ultrasound after 2 week. (Continue previous medicine).
Second Ultrasound (vaginally) done by radiologist on 02.05.2010 (72th day from LMP)
CRL is 0.52 cm-----6 week 2 day ( 3 week less corresponding from LMP).
No cardiac activity is seen.
Same day D&C (02.05.2010) by gynecologist .

Second Pregnancy (LMP 03.06.2010 i.e one month after first abortion) Unplanned
Positive pregnancy test on 07.07.2010 by home test kit.

First gynecologist visit on 07.07.2010 (34th day from LMP)
Doctor examine vaginally with TVS.
She prescribed medicine-
Folinext- one daily
Lupigest 200mg- one daily. (vaginally)

Second gynecologist visit on 24.07.2010 (51th day from LMP)
She refer TVS scan for viability.

First Ultrasound (vaginally) done by radiologist on 25.07.2010 (54th day from LMP)

Uterus is anteverted and bulky in size.
Show single gestational sac.
No fetal pole and yolk sac seen yet.
Sac is 12.6 mm corresponding with mean gest age of 5 week 2 day( 2 week less corresponding from LMP).
Impression;- Single Intrauterine gestational sac.

Doctor advised repeat ultrasound after 3 week for cardiac activity.
Second Ultrasound (vaginally done by radiologist on 14.08.2010 (74th day from LMP)
No fetal pole and yolk sac seen yet.

Second pinion from Dr. Nirmala Agrawal (Sant Parmanand Hospital, Delhi) on 16.08.2010.
She advised ultrasound.

TVS Report- Non viable intrauterine pregnancy.
Suction evacuation done under GA on 17.08.2010.
POC sent for HPE, LJ C/S report, RT TB (PCR)
All test result Normal.

Planning stop for 1year and 6 month.

Third Pregnancy
(Planning from July-2012, Medication start from April-2012).
Gynecologist Name- Dr. Deepi Maithani

First visit (06.04.2012)
Medicine prescribed:-
1 .Fol G1- once daily
2.Ovacare- once daily
3. Ebecid- once daily
4. Ecozyme – once daily for Husband

Test suggested:-
1.THS Profile:-
T3,Free; FT3 - 2.88 pg/mL (1.71 – 3.71)
T4,Free; FT4 - 1.10 Ng/dL (0.70 – 1.48)
TSH Ultrasensitive- 2.430 uIU / mL (0.350 – 4.940)


2. Torch Profile:
Toxoplasma, IgG      0.30 IU/mL (
Toxoplasma, IgM      0.05 Index (
Rubella, IgG      132.20 IU/mL (0.00 – 4.99)
Rubella, IgM      0.30 Index (Cytomegalovirus, IgG 235.70 IU/mL (0.00 – 5.99)
Cytomegalovirus, IgM      0.19 Index (
Herpes Simplex Virus 1+2, IgG 0.30 Index (0.10 – 0.80)
Herpes Simplex Virus 1+2, IgM 0.12 Index (0.10 – 0.80)
3. Lupus Anticoagulant-
APTT
Patient value -          35.40 SEC (28.60 - 41.10)
Control value-          35.20 SEC
PTT-LA          45.20 SEC (41.40 - 43.40)
DRVVT          No Lupus-like Anticoagulant present     

Menstrual Cycle – 28.04.2012 ( period last for 1 and ½ day)



Second visit (04.05.2010)
Medicine prescribed:-
1 .B Long-F- once daily
2.Syp.Amycordial- twice daily

Menstrual Cycle – 26.05.2012 ( period last for 4 day)
Planning start after next cycle
Doctor advice for consultation on 3 day of period
Menstrual Cycle – 24.06.2012 ( period last for 4 day)
Third visit (26.06.2010)
Medicine prescribed:-
1 .Folgel Plus- once daily
2.Ovacare- once daily
3.Syp.Amycordial- twice daily
4.Ecosprin – once daily
5.PPZ Gel- After dinner

No period at time. We hope pregnancy. All pregnancy symptom present.
Spotting like period on 23.07.2010 ( i.e 30th day from LMP).
Next day consultation with doctor . Doctor advice urine pregnancy test after 2 day.
Pregnancy test negative and repeat pregnancy test after 7 day negative.
Fourth visit (01.08.2010)
Doctor advice continue planning with medicine
1 .Folgel Plus- once daily
2.Ovacare- once daily
3.Syp.Amycordial- twice daily
4.Cifzer – once daily
5.PPZ Gel- After dinner
Pregnancy test Positive (27.08.2012)
Fifth visit on 27.08.2010 (35th day from LMP)

1 .Folgel Plus- once daily
2.Duphastone(10mg) - twice daily
3.Ecosprin – once daily
Advice:- USG after 7 day to confirm exact age of gestation.
First Ultrasound (Pelvis) done by radiologist on 04.09.2010 (43th day from LMP)
Uterus appears normal in size anteverted. No focal lesion seen.
Endometrial lining is well seen,is central and appears thickens (13mm)
Decidual reaction (Suggest repeat USG after 2 week)

Sixth visit on 04.09.2012 (43th day from LMP)
1 .Folgel Plus- once daily
2.Duphastone(10mg) - twice daily
3.Ecosprin – once daily
4.Argipreg Sachet- 1X 7 day
Advice:- USG after 15day.
Second Ultrasound (Pelvis) done by radiologist on 19.09.20102 (58th day from LMP)
Single live fetus in intrauterine gestation sac is seen.
Fetal cardiac activity is well seen.
CRL is 6mm-----6 week 3 day ( 1 week 6 day less corresponding from LMP)

Same as first pregnancy

Seventh visit on 19.09.2012 (58th day from LMP)
1 .Folgel Plus- once daily
2.Duphastone(10mg) - thrice daily
3.Ecosprin – once daily
4.Injection Lupigest (5000 IU)
Test Suggested:- CBC,ESR VDRL,HIV I&II, HBS, RBS,TSH, Rubella IgM.
All test reports are normal except:
Glucose Fasting     103.00 mg/dL          (70 -100 )
ESR                34               (0 – 20)
8th visit on 04.10.2012 (73th day from LMP)
Complain about burning sensation in palm and heal from conception. Also fever between 99-100 but no fever like feeling.
1 .Folgel Plus- once daily
2.Duphastone(10mg) - thrice daily
3.Ecosprin – once daily
4.Injection Lupigest (5000 IU)- After 2 week of first injection
5. Syr. Neeri
Brownish discharge on 08.10.2012. informed doctor. She advice take 3tab- Duphaston immidiatly and Limcy. Discharge stop. Again brownish discharge start from 15.10.2012 and it become darker day by day. We consult doctor. She advice Ultrasound.

Ultrasound on 17.10.2012(87th day from LMP).
Fetal cardiac activity is not seen.
CRL is 10 mm-----7 week 1day ( 5 week 2 day less corresponding from LMP)
Impression:- Missed Abortion
i.e fetal growth stop after inj. Lupigest (5000) start. Its my opinion.

Medical abortion done on 17.10.2012.