Is my body killing my babies?

[escapeartist]

I am having a tough time dealing with my second missed miscarriage - as it is exactly what happened first time round?

I live in a country where they do viable scans at 6 weeks and both times they found a strong heartbeat and a perfect-for-dates embryo. Then both times I had a subchorionic haematoma, the first time with only minimal bleeding, this time a lot of bleeding, both red and brown.

At 7.3 both times I had another scan to investigate the bleeding - it seems that both times the embryo;s growth had slowed down a lot. First mc it measured 6+4 (only 2 days more than my first scan, despite the fact that they were a week apart), second measured 6+2 (1 day bigger than the week before).

Both times a week later there is no heartbeat and I have an ERPC.

It seems to me that the emrbyos are viable, yet my body is stopping them from growing right... Anyone know much about this? I would like to see someone about it, though have limited options where I am... Any recommendations from the UK?

I am not sure I want to get pg again - I'm not so much hurting because of my mc (if they could show me that it was a random event I would feel much better) but because I feel like my body is "killing" my (and my sweet DH's) babies... :(

[kat2504]

Since you have had embryos both times with your pregnancies, rather than empty sac miscarriages, you should be able to persuade a doctor to carry out some blood tests. Especially since you have had the haematoma both times.

After 2mc I persuaded mine to start basic testing and they found some blood clotting issues, one clearly positive test, one borderline positive test for lupus anticoagulant. I'm pregnant again, but only 7 weeks and earlier this week I was started on clexane injections. Usually they wait for 3 miscarriages before testing but in your case they might make an exception.

[hopefulgum]

escapeartist - I'm so sorry for your losses.

I too had two miscarriages in a row (after 5 healthy babies), so have had some investigations. In my case, I also saw healthy heartbeats in both babies, at 8 weeks and 7+5. Both were mmc at 10 weeks and 9 and a half weeks. My blood tests showed that I might have an underlying auto-immune condition, but it seems that may not be the issue.

We've had chromosome studies done, but only have results for the first miscarriage, and it seems that it was a chromosome issue (trisomy 13) that caused the first miscarriage. Still waiting on results for the next miscarriage.

I've been told it is a "random" event, and in my case a much more likely random event because I'm over 40. I wouldn't have thought a random event would hit me twice, but it does look like that.

I really would press your doctor for some recurrent miscarriage testing. It is worth knowing - it may be as simple as taking aspirin during your pregnancy or extra folate.

[escapeartist]

Thank you both - you have confirmed that I should push for tests and I spoke to my Dr yesterday. She was v dismissive again, saying that "these things happen" and I am lucky they didn't happen later and it's "all for the best"... I found her patronising and it made me very upset. Especially as I have a history of recurrent miscarriage on my mum's side (grandma had 8 pregnancies - 3 DC's, 4 mc's and one stillbirth) as well as stroke and DVT in the family. I am only 30 and v healthy (was a professional athlete and still train) so it's not lifestyle related.

I have booked an appointment with a different doctor - another ob/gyn who is also specialised in recurrent miscarriage. It is all private, as I'm not currently in the UK, so if I'm paying I might as well have the support that I need.

Thanks again! Kat all the best in your pregnancy and good luck with the clexane.

Hopefulgum thanks for your advice and I'm sorry for your losses :( Good luck in the future.

[Iggi999]

I think what you've experienced could be consistent either with something like clotting/natural killer cells issues, or with a chromosomal abnormality. Testing is the only way to know, though having said that I've had high NK cells AND an emryo with a trisomy. It's very hard not to have answers, isn't it. Even after two mc, there's no reason why the next one won't be fine. Though I wish I'd had tests done after 2 (I've had 4 now).

[Iggi999]

I've just read your latest post OP. If anyone told me my babies dying was "for the best" I would have punched them in the face.

[escapeartist]

Thanks Iggi999 About her comment - it really did upset me! I was not sure if I was just being oversensitive, as only have the ERPC a few days ago and I'm still a bit hormonal...

In terms of NK cells - are they responsible for losses after hb too? And do they usually cause mmc or complete mc? Sorry if I sound clueless... Trying to find out about as much as I can before I see the next doc next week, so I can ask the right questions.

[Iggi999]

Hi there. Not an expert, so I might be wrong! As far as I know, they can be responsible for slightly later losses two (I've had two with hb, 2 without). Of course even if you have high NK cells, you could still have suffered a chromosomal abnormality. The main things I'd want tested for are clotting disorders (for which they'd advise aspirin and possibly heparin) or immune issues (including nk cells) for which steroids are prescribed. BUT not every doctor agrees with this treatment, hence why lots of women end up seeing specialists privately. I don't think the mc/mmc makes a difference, I think bodies just catch up with what's going on at different rates. Good luck

[escapeartist]

Thanks everyone for all your replies!!
I had a full thrombophilia work up, privately, and they found me positive for three different mutation that can cause blood clots in pg!!
My dr, even after seeing the results, maintained that most likely they were random events. Still!
I did my research (I'm a part-time scientific journal proof reader, so have access to BMJ and other good journals) and found that in fact two of the three mutations (pai-1 and factor II) are linked with recurrent miscarriage as well as other pg complications. So I went and spoke to a haematologist and she said the problem is obvious (and that the pathology itself is pretty clear) and that this particular problem is treatable. We are discussing treatment (for next time, when I get the courage again).

My dr called me about an hour ago to say she "has had a think" and she now thinks that it is in fact a clotting problem!!

I truly believe that (especially in countries with no central NHS like where I live) we need to take charge of our own investigation, find out about as much as we can and talk to specialists when needed. I am sure that a lot of gynaecologists might not know the most recent research on this, while a haematologist/gynaecologist would be much more informed and up-to-date!

[kat2504]

GPs often aren't up to date with very much at all sadly, and are not always that keen to refer you on to someone who does know.
Hopefully you will get a good treatment plan in place and will be able to give it another go soon. I tested postive for the lupus anticoagulant and am on clexane now. Obviously, it can't prevent genetic abnormalities which cause miscarriage, but it may stop me miscarrying a healthy baby. I think the success rate is about 78% or thereabouts, so the same as people who don't have a history of miscarriage.