G4P0M4 uterine abnomality


0 Posts
Reply G4P0M4 uterine abnomality Posted on: Aug 30, 2011 at 10:48am
Hi Dr Braverman

I live in Australia, but found your webpage via an American based forum.

I'm 28 years old, and was diagnosed with a (right) unicornuate uterus about 10 years ago after years of terribly painful periods. After a couple of investigative laps, the left rudimentary horn was excised, relieving some of my pain. Mild endometriosis was also discovered. Incidentally, I only have the single left kidney. The doctors warned me that I would likely experience some complications in the later part of pregnancy, like PTL or IUGR, and would have to have a caesarean. They considered my miscarriage risk to be the same as any "normal" woman.

In the last 2 years, I have conceived four pregnancies naturally. Conception is not an issue for us. My first ended spontaneously at 12.5 weeks, after showing healthy growth and heartbeat on ultrasound multiple times. Because of my history, my doctor chose to run the RPL panel after this first loss "to be safe". (ANA, APA, PTT, Coag screen, TSH, thyroid antibodies, Lupus Anticoags, Factor V Leiden, homocystiene, Fasting insulin, etc) All the results returned normal.

The following pregnancies ended at 9,8 & 7 weeks, and I have had D&Cs for each. Each pregnancy showed healthy heartbeats and growth, except the second one, (9wk) which showed a slow heart rate at about 8.5 wks. We had previously seen a normal heart rate with that pregnancy.
Also, the we have had the babies' chromosomes tested each time, and the results have been normal for the first three. I'm still awaiting the results for the fourth.
After my second loss, both my partner and I were karyotyped, and the results were normal. I also had an MRI and uterine doppler to check blood flow to the uterus.

I have been diagnosed with sub chorionic hemorrhages via ultrasound with each of the four pregnancies, and have had bleeding with each of them also, ranging from mild spotting to gushing. I have had progesterone tested, with normal results, and even tried one pregnancy with pessaries "just in case'.
The last two pregnancies I have been on high dose folic acid and aspirin.

Doctors continue to tell me that my losses are too early to be attributable to my uterine anomaly, but they seem unable to pinpoint a reason. The reason that I came to your site is because I read that you believe that after three losses, the chances of immunologic causes are quite high.

My question is whether you would consider my case to have possible immunologic causes, or whether you consider it likely to be related to my uterus? Personally, I have always felt that the may be some sort of blood or blood flow issue to my uterus, and that it must be related somehow to the anomaly. The odds of the condition itself are so small, it seems crazy to think that I might have another rare, totally unrelated condition.

I'd appreciate any info or comment you can provide.


Dr. Braverman

2026 Posts
Re: G4P0M4 uterine abnomality Posted on: Sep 5, 2011 at 9:28pm
Yes you do have to suspect some other cause at the uterine anomoly most likely is not the cause. I too suspect immune here. I can run a full panel on you and guide you from here, I treat many patients in Australia. Please call my office and schedule a phone consultation.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.