Hi everyone,
First time poster, long term lurker!
I have experienced 2 early pregnancy losses (first pregnancy twin pregnancy in Dec 2024 at 11 weeks and second a singleton pregnancy in Mar 2025 at 10 weeks) and was after some advice on next steps/what you would do in my shoes.
Medical history of relevant: my BMI is >30 since my first pregnancy, I have hypothyroidism (but levels all in normal range during both pregnancies) and I suffer from ovarian cysts, endometriosis and adenymyosis.
My hospital appointment to discuss my miscarriage is not until Jul 2025, but I’d like to TTC before this date. If there is something I could be proactive about to prevent a third loss based on my blood results below I would be all ears.
A few days before my 10 week scan for my second pregnancy which confirmed silent miscarriage and baby’s heartbeat having stopped at 8.5 weeks, I had my first midwife appointment. All blood results from that appointment are within range except:
Fibrinogen level
- 4.5 g/L (High)
- Reference Range:
- 1.6 g/L - 3.8 g/L
Unfractionated heparin (APTT ratio)
- 0.8 ratio (Low)
- Reference Range:
- 2.0 ratio - 3.0
Vitamin D level, blood
- 42 nmol/L (Low)
- Reference Range:
- 51 nmol/L - 125 nmo
Would you advise I do anything on the above before TTC or once I fall pregnant again? I was taking my folic acid and daily vitamin D supplements.
I don’t know if my midwife would be open to discussing the results with me and my experience with GPs has been poor (but open to your experiences/suggestions).
If I become pregnant for a third time, should I be trying to arrange a midwife appointment earlier than the 8-10 week appointment to get advice/do bloods? Is that even an option?
Finally, a strange thing that happened when I was with the nurse in the EPU after my silent miscarriage was confirmed in my second pregnancy, the nurse asked what blood thinning medication I was on due to me having a previous miscarriage and having experienced spotting during this pregnancy. I said I was prescribed progesterone by the EPU a few weeks prior, but that I was not prescribed anything else. She seemed surprised that my midwife had not prescribed me anything for blood clotting given my previous history of miscarriage, but I advised I’d only had my first midwife appointment a few days prior and when would they have known to prescribe me that? She didn’t say much after that but when I saw the doctor to discuss surgical management she asked again if I was on injections for blood clotting and I said no. This could be because they were booking me in for surgical management the next day and said I would need to have stopped taking that blood clotting medication for 24 hours before surgery, but the first nurse appeared genuinely surprised I wouldn’t have been prescribed them. This may be unrelated, but there was a cyst found inside the sac but it was clear and the notes don’t mention blood.
When Googling the above blood test results that are outside normal range, I see they’re to do with blood clotting so trying to figure out if this is relevant and if I should push for some sort of medication or advice based on my history of pregnancy loss and the results above or as they’re not too outside the normal range am I overthinking?
I’d appreciate your thoughts - thanks so much in advance 🙏🏼