Recurrent Miscarriage in Delhi
Investigation and management after two or more pregnancy losses.
What recurrent miscarriage involves
Two consecutive miscarriages warrants investigation. Around half of recurrent losses have an identifiable cause — chromosomal, uterine, hormonal, immunological or clotting related — and in many of those cases treatment substantially improves the next outcome.
The other half have no cause found, which is hard to hear but not hopeless: the majority of these couples go on to a successful pregnancy with supportive care and close early monitoring.
Who this is for
- Two or more miscarriages, consecutive or not
- Any second-trimester loss
- Known uterine anomaly or previous uterine surgery
- Known thyroid, diabetic or autoimmune disease
Not everything on this list means you need this treatment. The workup comes first, and the recommendation follows from what it shows — not from what was booked before you arrived.
Step by step
Parental karyotype
Blood chromosome analysis of both partners to look for balanced translocations.
Uterine assessment
3D ultrasound or hysteroscopy for septum, adhesions, fibroids and chronic endometritis.
Blood workup
Antiphospholipid antibodies, thyroid function, HbA1c, prolactin and thrombophilia screening.
Next pregnancy plan
Progesterone support, low-dose aspirin and heparin where indicated, with early and frequent scans.
Your results, in writing
Whatever the outcome of recurrent miscarriage, you leave each stage with the findings written down — what was done, what was found, what it means, and what the options are from here. Reports are issued the same day wherever the laboratory allows it.
Case study: Two losses, and an answer on the second visit
32, Kalkaji · two miscarriages at 9 and 11 weeks
What she came in with
Two losses in eighteen months, both after a heartbeat had been seen. She had been told to try again and come back after a third, which is advice that belongs to an older guideline.
What the workup showed
Antiphospholipid antibody testing showed a persistently positive lupus anticoagulant on two samples twelve weeks apart. Karyotypes, thyroid function, glucose and a 3D uterine assessment were all normal.
What we did
A diagnosis of antiphospholipid syndrome. The next pregnancy was managed with low-dose aspirin from the positive test and low molecular weight heparin from the first ultrasound confirmation, with fortnightly early scans.
Outcome
An uncomplicated pregnancy delivered at 38 weeks. Heparin was continued for six weeks postpartum.
The point of this case
Investigation after two losses, not three, found a treatable condition with one of the strongest evidence bases in obstetrics. Waiting would have meant a third avoidable loss.
Illustrative case. This is a composite of presentations commonly seen in this practice, written for explanation — it is not the record of an identifiable patient, and no individual's details are used. Outcomes vary, and nothing here is a prediction of what will happen in your case.
What is different about having this done here
Investigation begins after two losses, not three
Products of conception sent for karyotyping where available
Chronic endometritis specifically looked for
Early pregnancy monitoring built into the plan from the positive test onwards
Treated by the consultant, not by a rotating team
Dr. Tiwari performs the scans, the procedure and the follow-up herself, and looks after any pregnancy that results. Over a long treatment course that continuity is the difference between being known and being processed.
- MBBS, MS (Obstetrics & Gynaecology), FNB (Reproductive Medicine)
- Over ten years in reproductive medicine and gynaecological surgery
- Consultations and scans at Mother's Hope, Katwaria Sarai; theatre work at SHE Delhi Hospital, Greater Kailash II
- Itemised costs given in writing before anything begins
Areas we see patients from
Both locations are in South Delhi. Patients travelling from further out have appointments grouped to cut down the number of trips.
Questions about recurrent miscarriage
What causes recurrent miscarriage?
Chromosomal abnormality in the embryo is the commonest single reason, especially with increasing maternal age. Uterine anomalies, antiphospholipid syndrome, uncontrolled thyroid or diabetes and chronic endometritis account for most of the rest.
Does progesterone help?
In women with recurrent losses and early pregnancy bleeding, vaginal progesterone has good evidence behind it. Given routinely to everyone, the benefit is much less clear.
What are our chances next time?
After two or three losses with no cause found, the chance of a successful next pregnancy is still around 65–70%. That is a genuinely encouraging number.
Talk it through before you commit
Consultations run for a full hour. Bring any previous reports — they are reviewed properly, not repeated.