Patient's question:
I have been married to my wife for almost seven years. She has been pregnant two or three times, but each time she miscarries after five to six months. This has been very frustrating for me. I have also gone to a large hospital for check-ups, and all the test results were normal. Could you please tell me what might be the reason for this? Is there any effective treatment available?Detailed medical history and consultation purpose:
Duration and frequency of symptoms: Each time it lasts for five to six months
Current general condition: None
Medical history: Previously, one hospital diagnosed her with hepatitis C, but another large hospital found no such condition.
Previous diagnoses and treatment history and effectiveness:
Doctor's answer:
Hello:Considering habitual abortion. For those with a history of habitual abortion, it is recommended to regularly measure basal body temperature. If the menstrual cycle is slightly prolonged but basal body temperature does not decrease, treatment can begin if pregnancy is suspected. Avoid physical labor and mental stress, and refrain from sexual activity. Begin oral vitamin E supplementation at 100mg/day, along with vitamin B and C. Early β-hCG and ultrasound examinations should be conducted to confirm the diagnosis. Identify the cause and treat accordingly:
1. Chromosomal abnormalities: Prenatal diagnosis should be performed. If the male partner has chromosomal abnormalities, artificial insemination with donor eggs (AID) may be considered with the consent of the couple. For other genetic factors, the mode of inheritance must be considered. For those with a clear genetic predisposition and no effective prenatal diagnosis methods, it is advisable to discourage termination of pregnancy.
2. ABO blood type incompatibility: For IgG antibody titer II region or higher, the following herbal decoctions should be taken:
- Chong Chen Decoction (Chong Chen 10g, processed Da Huang 3g, Huang Qin 12g, Gan Cao 10g) – 10 doses each in the early, middle, and late stages of pregnancy.
- Yi Mu Wan (Yi Mu Cao 500g, Dang Gui 250g, Chuan Xiong 250g, Bai Shao 300g, Guang Mu Xiang 12g, ground into fine powder and mixed with honey to form pills, each weighing 10g) – 1 pill per time, 2–3 times per day.
Regular follow-up visits should be scheduled to monitor changes in antibody titer, in addition to obstetric conditions.
For neonates with Rh hemolytic disease, exchange transfusion is used. Preventing complications after exchange transfusion is key to successful treatment. For pregnant women with severe Rh hemolytic disease in their children, prenatal plasma exchange can reduce the amount of antibodies in the mother, lower antibody titer, and alleviate the condition.