recurrant abortions

drsaif

0 Posts
Reply recurrant abortions Posted on: Jan 3, 2011 at 5:03pm
dear dr braverman SIR....
am dr saif,general surgeon in mumbai.india.
this is regarding mywife uzma begum ,28yrs.blood gp-A positive.
short history..
case of 10 recurrant abortions.......all in the first trimester...between 6 and 8th wk of preg.
every time cardiac activity is observed....and stops by the beginingof 8th wk....
and every time dnc is done.
EVERY PREGNANCY treatment given inj HSG,PROGESTERON,FOLICACID,
5TH preg -aspirin and prednislone 40mg.
6th and 8th was with LMWH and ASPIRIN.
Invastigations...as follows...
blood gp..A positive..
TORCH Ig M- NEGATIVE
Ig G-POSITIVE for RUBELLA ,CMV and HSV.
ANTI PHOSPHOLIPID ANTIBODIES Ig M-NEGATIVE
Ig G-NEGATIVE.
ANTI NUCLEAR ANTIBODIES-POSITIVE(S/O.BORDERLINE)
ANTI ds DNA- NEGATIVE.
ACL Ig A-NEG
Ig G-NEG
Ig M-NEG.
LUPUS ANTI COAGULANT-NORMAL RANGE.
APTT-NORMAL RANGE.
KARYOTYPING-Both husband and wife normal......
( repeated again to conferm from differnt lab,came as normal.)
KARYOTYPING-Products of conception.
-TURNERS SYNDROME,45,XO
-46,--(del 5q)
-46,--normal.
-47,XX+16
HYSTEROSCOPY-NORMAL .
T3,T4,TSH-NORMAL RANGE.
GLYCOSYLATED HEMOGLOBIN-4.6(NORMAL).
ESR-18
SR INSULIN LEVELS-NORMAL.
HUSBAND SEMEN analysis-normal.

THESE IS SHORT HSTORY AND INVESTGATIONS DONE.
I WOULD BE THANKFUL,IF U DRAW SOME CONCLUSION......AND WOULD GIVE ME UR VALIUABLE ADVICE....
THANKING YOU...
WITH WARM REGARDS..
DRSAIF 34YRS OF AGE.
PH.+91 9892246100.
MUMBAI,INDIA

Dr. Braverman

2026 Posts
Re: recurrant abortions Posted on: Jan 3, 2011 at 11:53pm
Hello DrSaif,
I would be happy to help you , this is a long and detailed history that certainly has evidence of immune rejection with the postive ANA and at least one normal genetic testing on the D and C. There are still many issues to discuss i.e. the timing of starting LMWH and prednsione, what were all the immune testing results as well as HLA testing. Was the insulin fasting, was a HgbA1C obtained.
You may also be a candidate for our neupogen trial.
Please call my office and schedule a time that we can speak , I will go over all your records and fill in any testing (I can order any of my immune panel any where in the world), then I can give you concrete recommendations. Im sure I can help you determine the cause for your wife's losses and recommend a treatment. We just have some work to do first.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

drsaif

0 Posts
Reply Re: recurrant abortions Posted on: Jan 4, 2011 at 6:55pm
Respected dr Braverman sir,
i am very happy for ur kind reply......
regarding the quiries by u....
1- LMWH WAS STARTED AS SOON AS CARDIAC ACTIVTY WAS NOTED.......AND REGARDING PRODNISILONE..WAS STARTED LITTLE LATE,AFTE CARDIAC ACTIVITY.......
2-IMMUNE TESTING -I HAV MAILED U,WHAT ALL TESTS I HAV GOT DONE.....
REGARDING HLA ,IWILL GET IT DONE...
3-INSULIN LEVELS WAS DONE IN FASTING...
4-HgbA1c DONE IS IN NORMAL RANGE-4.2

Am planing to get the following tests done...as per a other doctor to r/0 ACQUIRED THROMBOPHILIA according to him
sr.homocystine levels.
protine C & S
Factor V laden
Anti-thrombin III
Sr.TSH
Sr.prolactin

any other tests would u feel to get it done...please advice me...
thanking u....
with regards...
dr saif

Dr. Braverman

2026 Posts
Re: recurrant abortions Posted on: Jan 6, 2011 at 3:23am
Please call Kim back at office and she will discuss the consult with you regarding your training, I will help you.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.