How to give birth to the child with a clottage, otrits.rezusom and after the stood pregnancy???

[wicked]

Hello!

I wish to address with the problem to the experts who are present at this forum. To tell the truth, I at all do not know to to me it is necessary to address the question, to genetikam, to endocrinologists or gynecologists... Perhaps, my problems will seem not such serious as I represent them to myself now, but, nevertheless, I ask to share the experience of doctors.

To me 22 years, married already more than 3 years. Group of a blood 3-, at the husband 2 +. A sexual life since 17 years, monthly with 12, a cycle of regular, 28 days, for 4 days, averages.

In February 2004 (second) has learned or has found out about the pregnancy the gynecologist has put term of 5 weeks ber-. All was good up to the first US as it or he was done or made on a full bladder I am natural has probably drunk too much with waters and up to a cabinet or study is already hardly cunning.. And when went has felt any humidification in the bottom of (nothing hurted or was ill;was sick, and did not pull neither before, nor after), it has then appeared what is it were bloody allocation, as during monthly. The doctor has appointed or nominated repeated US in a week, and by its or his results the conclusion about destruction of a fetus on 5 week (though real term should be 10 weeks) has been made.

In an extract it has been written *quot; incomplete abortion at not developing iNON?N???O?*quot;:confused:

At the analysis on IPPP, have revealed a ureaplasma and gardnerellu. Strangely enough, but I them treated 2 times, and at different doctors, but they and have not disappeared....: (

Now about that could affect or influence.

The first pregnancy has ended in 1999 with abortion on 8 week (the doctor on Uzi spoke, that the child developed normally, sootvetstveno to term, healthy).

In 1999 there was the pleural pneumonia caused or called by a clottage of a pulmonary artery in the spring.

In 2001 was a clottage of the bottom ileal vein on the left leg or foot, owing to acceptance Ok *quot in the spring; ???N?O*quot;. After treatment has put Naval Forces, in the summer 2003 has removed or has taken off, owing to occurrence of a small inflammation.

With clottages laid in 1-st town hospital... Many histories about ber- have had heard plenty of women with such disease, many laid on sohraneniii from the very beginning, legs or foots up, others had problems on vynashivaniju, and t.d

In connection with the above-stated, arises much voposov:

1. The reasons stood ber-

2. How effectively to cure a ureaplasma and gardnerellu: including whether treatment for men and for women coincides

3. It is necessary to hand over what analyses still

4. To what doctor (am) it is necessary to address

5.....



Simply I do not know. That else it is possible to ask... It is a lot of questions...

The main thing certainly how to make so that, whenever possible there were no problems with vynashivaniem, consider, that there was an abortion at otrits.rezuse, a clottage, infections..



I thank everyone who will respond!

[svv]

The first pregnancy has ended in 1999 with abortion on 8 week (the doctor on Uzi spoke, that the child developed normally, sootvetstveno to term, healthy).

In 1999 there was the pleural pneumonia caused or called by a clottage of a pulmonary artery in the spring.

Abortion under medical indications? Or.. On social?

Thromboembolism of a pulmonary artery (TELA) on a background of reception of oral contraceptives?

3. It is necessary to hand over what analyses still

The general or common analysis of a blood (thrombocytes interest)

An. Bloods on antibodies to a cardiolipin

Wassermann reaction



There is such illness or disease, is called antifosfolipidnyj a syndrome, is characterized among other nevynashivaniem pregnancy, spontaneous clottages (it if TELA it has not been connected with reception OK).

Infrequently happens, but all...

[Varvara]

Since the first days and for all period of pregnancy (and also in the postnatal or puerperal period) - purpose or appointment of preventive doses of a low-molecular heparin; it will help or assist and to inform pregnancy if is to-or a thrombophilia; at presence antifosfolipidnogo a syndrome not bad to add to it or this small doses of Aspirinum (75-100 mg day). Also it is desirable to find still the internal doctor who would supervise you on this treatment (periodich. Monitoring of thrombocytes).



From analyses would add ACHTV and volchan. Anticoagulant.

It would be possible to spend analyses under the claim/establishment of the reason of a thrombophilia, but it is the extremely dear or expensive, and tactics at pregnancy identical.

[99]

To A.V.Rodionov: first, I wish to thank you for your participation.. It is very pleasant, that at this forum really are interested in problems and accept active participation in resolution of problems.



As to your remarks:



Abortion under medical indications? Or.. On social?

.. On social....: (



Thromboembolism of a pulmonary artery (TELA) on a background of reception of oral contraceptives??

No.. To tell the truth, not only I, but even doctors did not know, that with me, and whence at 17 girls the pleural pneumonia has undertaken, considering, that no preconditions for its or her occurrence existing.. I.e. I did not catch a cold or did not chill, there was no tussis, the only thing, there was a temperature which constantly kept before hospitalization during, novernoe, two weeks. We thought, what is it simply flu but after me has already finished potojannaja a nagging pain in joints of arms or hand:confused:, I have seemed to the familiar doctor, have made a roentgen, and have found out, that at me a half-lung dark... And only in 2 years when me have put in 1-st town with an occlusive clottage of the bottom ileal vein after OK, the doctor to me has told or said what is it there was just a thromboembolism of a pulmonary artery, and to me has still carried, that the thrombus has not departed to heart or a brain.



The general or common analysis of a blood (thrombocytes interest)

An. Bloods on antibodies to a cardiolipin

Wassermann reaction



There is such illness or disease, is called antifosfolipidnyj a syndrome, is characterized among other nevynashivaniem pregnancy, spontaneous clottages (it if TELA it has not been connected with reception OK).

Infrequently happens, but all...



.. Really in 99. I had a spontaneous clottage??:eek: (by the way, he at me hereditary, from maminoj mums)

.. Has entered the name on medium on reception as will make all analyses, I shall necessarily tell.:rolleyes:



Yours faithfully,

Tess_a.

[Chubenko Sergey]

To Dr. Vad: thanks for your references! If will allow, would like to specify something:



1. It is necessary to hand over what analyses to the husband?

2. Whether identical treatment from garner. And ureapl.budet for me and for the husband? (whether imet value or meaning;importance body height, my weight and the husband, considering, that I weigh 56 at body height 169, and the husband 110 at body height 193).

3. Whether probably to not use at all a medicine at pregnancy, I have in view of as a heparin, Aspirinum, and all rest?



Yours faithfully, Tess_a.

[Hugo]

Dear Tess a!



Presence of family predisposition, deep vein thrombosis on OK, TELA in doubt, (not developing beremennostej) allows to assume 2 early abortions, that predilection to clottages (thrombophilia) should be excluded first of all and inspection needs to be begun with you.



Presence of the first -episode in doubt on vone will inflame. Process; presence of the second on background OK assumes, that at any subsequent risk (pregnancy, posleoper. The period, dlit. An immobilization, etc.) you need to spend PROPHYLAXIS of a clottage, what a trace. The episode did not become for you fatal. To prof- concern: a heparin including NMG, bandaging of legs or foots, Aspirinum (least effective) for ALL brave period. Considering your problems with vynashivaniem purpose or appointment NMG for all period of pregnancy and in after sorts or labors not only will raise or increase your chances to inform pregnancy (from 30 % up to 70 %) but also to protect your organism from a thrombogenesis in veins (on 60-70 %).

[sorrylex]

Tess_a,

I support or maintain those references which are given by doctors Rodionovym and Dr. Vad.



One more nuance which should be specified - how, more precisely, is diagnosed by what method a ureaplasmosis and a bacterial vaginosis? Treatment?

[lord_vidocq]

Tess_a,

One more nuance which should be specified - how, more precisely, is diagnosed by what method a ureaplasmosis and a bacterial vaginosis? Treatment?



Way: did or made always smears on these infections.



Bacterial vaginosis have found for the first time in the beginning 2003, the doctor has appointed or nominated treatment (precisely a dosage I do not remember, I remember approximately, that lekartsva were not from cheap): difljukan, summamed, Trichopolum, Nistatinum, oksigrissant, lineks, Polyvitaminums, -suppositories... Like all..



Then in the summer (2003) I have handed over once again, and there there was again she, but now in the company with a ureaplasma: already other doctor to me has appointed or nominated other treatment. For ureapl.: o??yOaoN?/erythromycin (it or him accepted), Nistatinum, bifidum bakterin and viferon. For .: and Nistatinum.



By results of smears in March 2004 (when there was a pregnant woman) - all the same picture.:mad:



Treatments it was not spent, while, simply already at all I do not understand where, and to itself to address in occasion of their treatment... I am afraid, that will be again one antibiotics, and result nolevoj!



How you consider or count, whether correct treatment has been appointed or nominated, and if there is no that that else it is necessary to add?



Yours faithfully, Tess_a.

[Nermut]

You need to spend PROPHYLAXIS of a clottage, what a trace. The episode did not become for you fatal.

Considering your problems with vynashivaniem purpose or appointment NMG for all period of pregnancy and in after sorts or labors not only will raise or increase your chances to inform pregnancy (from 30 % up to 70 %) but also to protect your organism from a thrombogenesis in veins (on 60-70 %).



Approximately on 5-th week ber. I did or made UZDG the bottom extremities, results were good so my doctor from 1-st town has appointed or nominated to me sled.priem only in 3 weeks (at control PTI over an out-patient department). Therefore I now do not understand: if results UZDG were good, the first abortion, or all together means my thrombuses here at anything, and as the reason infections could serve, or?? 7:confused:



And in occasion of the 2 first items or points? How you consider or count?





1. It is necessary to hand over what analyses to the husband?

2. Whether identical treatment from garner. And ureapl.budet for me and for the husband? (whether imet value or meaning;importance body height, my weight and the husband, considering, that I weigh 56 at body height 169, and the husband 110 at body height 193).



Yours faithfully, Tess_a.

[K-7]

Dear Tess a!



nevynachivanie pregnancy because of a thrombophilia are connected with the microthrombuses formed in a placenta and by means of UZGD, PTI they not o??Oa????OO?O?n/prove to be true.



Available your anamnesis predetermines to that a thrombophilia as the reason of an abortion should be iskluchena first of all. The clottage o veins during pregnancy seldom arises right after conceptions, and more likely in 2-3 trimester when the hypercoagulation is especially expressed.



On the first 2 questions there is a following opinion (at least on the basis of napr. This clause or article):



The ureaplasma in shejke uteruses is found out at 2 of 5 normal women, at 2 of 5 pregnant women and at 3 of 5 with recurrent nevynashivaniem - not the fact that presence *quot is simple; florae or oaO?U*quot; conducts in 100 % to abortions, but only above risk (on 20 %). Especially, excision of pathogenic microbes or normalization of flora does not guarantee full vynashivanija.



Cervical colonization with U. urealyticum was found in 42.6 % of 310 normal pregnant women, in 41.6 % of 84 patients who underwent induced abortion, in 41.5 % of 41 normal fertile patients, in 53.3 % of 122 patients with spontaneous abortion and in 64.5 % of 76 patients with recurrent spontaneous abortion.



From Acta Obstet Gynecol Scand. 1987; 66 (6):513-6. Epidemiology and pathogenesis of ureaplasma urealyticum in spontaneous abortion and early preterm labor. Naessens A, Foulon W, Cammu H, Goossens A, Lauwers S.

[Za]

Good evening all!



Here has found results of some analyses which to me did or made during and after pregnancy.



By results of directions on a coagulogram from 26.03.2004

1. A fibrinogen - 2,35

2. PDF - otr.

3. The ethanol test - otr.

4. Trombinovoe time - 17,3

5. ACHTV - 34

6. PTI - 88,4

7. A retraction of a clot - 3,5

8. An antithrombic reserve of plasma - 97,8

9. Aggregation of thrombocytes - 14



By results of directions on a blood analysis on Rh antibodies from 26.03.2004 - Rh antibodies are not found out



By results of __-1 (method IFA) from 10.04.2004 (after a currettage):

1. The maintenance or contents of antibodies to OBM, S100, _ and ?O-WITH (in usl.ed.) (norm or rate from-25... Up to +30 .ed)

-64 -66 -65 -54

2. Result: the Hyporeactivity



By results of biohim.analiza bloods from 26.03.04

1. The general or common fiber - 65

2. A bilirubin the general or common - 24,9

3. A bilirubin connected - 7,2

4. A bilirubin free - 17,7

5. Sodium - 134,4

6. Chlorine - 97,2

Other parameters within the limits of norm or rate.



The gynecologist diagnosed pregnancy of 5 weeks 09.03.04.

The currettage was 08.04.04.



By results of US from 07.04.04:

In a cavity of the uterus amioticheskaja the cavity is deformed, an embryos abs, amioticheskaja the cavity corresponds or meets 6-7 ned.ber. (on MTS - 9,5 ned.)



By results of a histology:

In soskobe endometry with gravidarnymi changes, decidual... With diffusive or diffuse leukocytic infiltritsiej.. And something or something else (has not made out handwriting) about fragments of a fibrous tissue).



I ask experts to explain, whenever possible, results of analyses.

[Anastas.]

On koagul. To researches: similar that all in norm or rate, ACHTV is not increased - high probability of absence volchan. Anticoagulant (but it is necessary to look or see antibodies to fosfolipidam for exception AFLS) and naturally given researches are not sensitive to dr. To kinds of a thrombophilia; in biochemistry it is a little bit raised or increased obshch. A bilirubin due to konjugirovannoj fractions and how now or previous analyses?

[Isergey]

Tess_a,



If in the given failure of pregnancy also there is any contribution of a bacterial vaginosis and a ureaplasmosis their role - is minimal. More likely the modern attitude or relation allows to consider or examine;survey presence of a ureaplasma as possible or probable and in norm or rate *quot; i?OaON?n*quot; vaginalnoj florae.



You now are more likely concentrated to idea to achieve *quot; ?nNa?a*quot;, but the big sense in it or this is not present. You interests why twice spent treatment has not crowned a victory? Treatment should be spent together with the partner, for a bacterial vaginosis - imidazoles (ornidazol or Trichopolum + difljukan), summamed can be a variant for treatment of a ureaplasmosis. But treatment should be spent in parallel.

[Zeba]

To Chebotnikova T. and Dr. Vad: thanks for your participation and references!..:)





As to fresher analyses, I only today have handed over a blood on a heap of any parameters and components, and also on 13 IPPP. And still the doctor to me has appointed or nominated to hand over a blood on 12 hormones, to make US and a roentgen of a skull (area of a turkish saddle):confused: (it is interesting what for?)? And to descend or go to the oculist (to learn or find out, that with a myopia, at me now-4,2).

So all results at me will be, probably, to the extremity or end of this month.



Yours faithfully,

Tess_a.

[Ninel]

NO, ONLY NOT IT!



It is not necessary to try to involve in diagnostics of infections of an antibody - anything good for you it will not terminate. Simply already I ask to not give all blood so worthlessly, at any disease (even at a maternity fever) 12 hormonal parameters are not necessary simultaneously.



And the roentgen of a skull - this phrase sounds already absolutely exotically in our society.



Tess_a, what you do or make?

[Anzhik]

... At any disease (even at a maternity fever) 12 hormonal parameters are not necessary simultaneously.

Tess_a, what you do or make?



:o.. It not I, it to me the doctor have appointed or nominated all these procedures..

I here therefore was interested, whether the plan of inspection should be such at not developing pregnancy?!



And that, in your opinion, it will be necessary to make for revealing the reasons () nerazv.ber.??

[Aunt Zoe]

Tess_a,



The paradox consists that not developing pregnancy was once is not the indication for additional inspection (I I understand, that to you uneasy to realize such fact, but...)



That is actually the doctor, recommending additional researches, goes at you on an occasion, wishing you to calm and give to you to confidence. It is possible to choose from the list of accessible researches only what can really help or assist (markers AFS, for example,) from the list of hormonal researches - TTG, from infections - first of all AT to TSMV.



To you the antirhesus- after an abortion (both of time) has been entered?

[freeman]

Tess_a,



To you the antirhesus- after an abortion (both of time) has been entered?



I, to tell the truth, at all did not know that it is necessary to enter this preparation. Therefore I was not interested then, in 1999 about, whether have entered to me it or him or not. I believe, what yes, differently at me at a trace ber. Have found out Rh antibodies, so in fact?



And as to ner.ber., in hospital where to me did or made a currettage, for certain should enter it or him, in fact they had all my analyses. I shall try to specify at the doctor.



And in occasion of purpose or appointment by the doctor delivery of a blood on hormones my initiative here is not present, but I wish to look or see really at results, and suddenly it because of them (we shall assume, that AFS is nothing). Simply that in a trace. Time to be assured or confident on 100 % from what something can happens, and that will not affect or influence in any way.



_________________________

Yours faithfully,

Tess_a.

[Katish]

Dear doctor Chebotnikova!



It not seems to you, that data of first report Tess_a

*quot; In February 2004 (second) has learned or has found out about the pregnancy... The First pregnancy has ended in 1999 with abortion on 8 ?NnN?N*quot;

Not absolutely keep within definition *quot; was or former once not developing iNON?N???Oy*quot;?



Whether primary data *quot are comparable; In 1999 there was the pleural pneumonia caused or called by a clottage of a pulmonary artery in the spring. In 2001 was a clottage of the bottom ileal vein on the left leg or foot, *quot in the spring; with the international references or not?



In patients with multiple (two or more) episodes of VTE and/or women receiving long-term anticoagulants (eg, single episode of VTE-either idiopathic or associated with thrombophilia) we suggest adjusted-dose UFH or adjusted-dose LMWH followed by resumption of long-term anticoagulants postpartum (Grade 2C).



... women with recurrent pregnancy loss, a second trimester miscarriage, or a history of intrauterine death or severe or recurrent preeclampsia should be screened for underlying congenital thrombophilias.... since many of these women also have an increased risk of VTE, antithrombotic therapy should be considered in this population.



From Use of Antithrombotic Agents During Pregnancy: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy

Shannon M. Bates, Ian A. Greer, Jack Hirsh, and Jeffrey S. Ginsberg

Chest 126: 627S-644S.



About same of the Europe:



Patients who have hereditary antithrombin deficiency, antiphospholipid antibodies, a combined abnormality, or a history of a severe thrombotic event (pulmonary embolism or extended deep vein thrombosis) should be advised to use prophylactic heparin during pregnancy, starting during the first trimester. Postpartum prophylaxis should be given to all women with an increased risk for VTE.



Pabinger I, Grafenhofer H.Anticoagulation during pregnancy.

Department of Hematology and Blood Coagulation, University Clinic I, University Hospital Vienna, Vienna, Austria. From Semin Thromb Hemost. 2003 Dec; 29 (6):633-8.

[maiya]

Dear doctor Vadim!



In report Tess_a it is a question of the first pregnancy interrupted at will of the woman, i.e. about a medical abortion (abortion) as a result of the decision of the woman.







The first pregnancy has ended in 1999 with abortion on 8 week (the doctor on Uzi spoke, that the child developed normally, sootvetstveno to term, healthy)!

In February 2004 (second) has learned or has found out about the pregnancy. The doctor has appointed or nominated repeated US in a week, and by its or his results the conclusion about destruction of a fetus on 5 week (though real term should be 10 weeks) has been made.





And here the second pregnancy was not developing.



That has in addition informed on itself Tess_a, gives us all basis to investigate or research markers of a thrombophilia, irrespective of presence of the stood pregnancy in the anamnesis.



What we is or are going to to discuss?

[u4you]

Tess_a,



Each pregnancy of the Rh-negative woman a fetus having the +Rh-factor increases or enlarges chance of occurrence of antibodies to the Rh-factor (Rh-conflict) on the average by 10 %. And not so it is important, there were labors or pregnancy has ended with abortion. The fact of presence of antibodies is not illness or disease, it only raises or increases risk of development of hemolitic illness or disease of a fetus. In other words, antibodies to the Rh-factor to are at many pregnant women with Rh-, but the chance to have serious damage of tissues of a fetus (hemolitic illness or disease of a fetus) basically is very small. Such pregnant women of unit! I more than once wrote about it or this at a forum in other discussions. That is the Rh-conflict (presence of antibodies) it not a verdict but only an occasion to pay to you additional attention during following pregnancy.



To lower risk of immunization at the Rh-negative woman who are not having Rh-antibodies, after sorts or labors or abortion enter an antirhesus gammaglobulin.

[tatochka]

Dear Doctor Tatyana!



When patients write *quot;... Has ended aiOO?*quot;, it unless not spontaneous? It seemed to me. Usually speak, that *quot; has interrupted pregnancy, has made aiOO*quot;. Let us will judge Tess_a.



You fine know, all how much can cost trombofilicheskaja the panel of research and whether do or make it or her even in Moscow in full volume. As the nature of half from thrombophilias is not established or installed yet and goes under the stamp *quot; idiopathic OO?i?*quot;.



I am to be informed nevertheless an idea, that without dependence from researches for nevynashivanija, adequate actions already according to an available anamnesis are recommended the patient for prophylaxis of a clottage, and there is a high probability, that the heparin can raise or increase chances to inform the child. Whether there is an experience at whom in Moscow on conducting such patients?

[Natilla]

I would tell or say so, - the woman never will keep silent (more likely itself will pay your attention) to the fact of a misbirth.



In occasion of markers of a thrombophilia informative and accessible to research, - I personally would wish to know, that except for VA (cardiolipin), and indirectly ACHTV can be informatively for an estimation of risk of a clottage, before event.



The idea about prophylaxis of a clottage is good literally everything, I fine understand and I support or maintain your ideas about prospects and anticoagulants as a whole and the more so at the following beremennostjah Tess_a. In Moscow there are some centers developing a subject of a thrombophilia.

[Jaroslav]

When patients write *quot;... Has ended aiOO?*quot;, it unless not spontaneous? It seemed to me. Usually speak, that *quot; has interrupted pregnancy, has made aiOO*quot;.



Dear Vadim Valerevich! I from the very beginning found out this question:

The citation:

The report from rodionov

Abortion under medical indications? Or.. On social?

The answer:

.. On social....

[Esprit]

Dear doctor Tatyana!



Except for listed in the table (Kujovich JL.Thrombophilia and pregnancy complications. Am J Obstet Gynecol. 2004 Aug; 191 (2):412-24), still allocate the raised or increased concentration of the factor VIII (more than 150 %):



Marietta M, Facchinetti F, Sgarbi L, Simoni L, Bertesi M, Torelli G, Volpe A. Elevated plasma levels of factor VIII in women with early recurrent miscarriage. J Thromb Haemost. 2003 Dec; 1 (12):2536-9.



Dossenbach-Glaninger A, van Trotsenburg M, Krugluger W, Dossenbach MR, Oberkanins C, Huber J, Hopmeier P. Elevated coagulation factor VIII and the risk for recurrent early pregnancy loss. Thromb Haemost. 2004 Apr; 91 (4):694-9.