QuestionHello!
I have no children.
I was at the time 26yr old when I experienced a stillborn appox. 26 weeks'gestation on 06/12/05. I experienced a sharp lower abdominal pain with no vaginal bleeding, contractions, or rupture of membranes. I was induced for 4-days and delivered vaginally on 06/17/05. Autopsy showed cause of death INTRAUTERINE FETAL DEMISE (IDIOPTHIC STILLBORN). Medical reports from the hospital showed CYTOMEGALOVIRUS AB (igG) >13.20 (G). OBGYN said I may have had a past infection. Then OBGYN on 09/2005 checked CMV IgG values to be negative I should be at 0.0-0.8 and my values were 0.9. WHAT DOES THIS MEAN? The tissues taken at the autopsy submitted for cytogenetic analysis died.
Now 27 yrs. old, on 11/24/05 was the first day of my last menstral period and cycle is 25 days long. On 12/28/05 I was started on PREMETRIUM 100MG 1-capsule twice a day. OBGYN kept checking my hormone levels every week. On 01/05/06 OBGYN performed a vaginal sonogram to check for fetal heart beat. OBGYN found it present and I was appx.7 weeks pregnant. On 01/13/06 I had been experiencing back pain and then came vaginal bleeding. I had a miscarriage later on that day at 9:00PM at the hospital.
Now to my questions:
Did levels of the CMV levels affect my second pregnancy?
Due to the length of time that I was induced did it affect my second pregnancy?
Are there any additional testing that can be done ,BEFORE I get pregnant, to increase my chances of a full term pregnancy?
Could there be genetic problem if maybe what test should be done?
Thank in Advance,
Maria in Grand Prairie, Texas
AnswerStillbirth at 26 weeks gestation is almost always due to an infection. This causes premature rupture of membranes. It is usually difficult to induce the delivery of a stillbirth at that stage of pregnancy and it certainly can take 4 days for the delivery to take place. The autopsy showed that it was an idiopathic stillborn, which means that there was no cause found. The cytomegalovirus IgG of 13.2 means that you had produced antibodies, but does not mean that you definiitely had CMV. Usually, we do not start prometrium unless your progesterone levels are very low. It can't hurt, though. If your sonogram showed a 7 week fetus with a fetal heartbeat, you obviously had a viable pregnancy. Miscarriage occurs in 15-20% of every pregnancy. There is nothing you can do to prevent it and there is nothing you can do to cause it. At 7 weeks, we usually never find the reason for the miscarriage. It is totally different from a fetal demise after 20 weeks gestation. You CMV titers did not affect your second pregnancy. The length of time it took to deliver has no effect on future pregnancies. There are no tests you should do except your doctor can check your anticardiolipin antibodies for phospholipid disorder. Although there is always a risk of genetic problems, we don't recommend amniocentes unless you have a history of some genetic disorder. It is quite normal to have a miscarriage and occasionally you can have a fetal demise during pregnancy.I have had many patients who had three or more miscarriages and then went on to have 5 successful pregnancies. I have had women who had several babies and then had four miscarriages in a row. I have some women who have one baby, a miscarriage, then another baby, and then another miscarriage. There is no way to predict. Wait for a normal period and start trying to conceive. The risks are in your favor.
