Suggest treatment for absent fetal heart beat during pregnancy
Patient: i am a seizure disorder patient presently on oxycabazepine.i am pregnant but the growth is slow. my LMP was on 19/12/2009 (have irregular periods).according to that my baby shud be 9 weeks 06 d.but the recent usg shows 6 weeks 6 days.last week also had a usg which showed 6 weeks 2 days.fetal pole has appearedthis week but no heart beat.moreover i culd have conceived only after 6 of jan since had intercourse only after that.my doctor says to go in for D&C.please advice. Doctor: Hi there,,Since you have irregular periods its possible that you must have ovulated late and that's why the pregnancy is 6-7 weeks at present. So do not worry about the dating of the pregnancy.More importantly since the fetal pole has appeared when compared to the previous report it would mean that there is some progress in the pregnancy.I would advise you to wait and get another scan done to check for fetal heart after 10 days of this one.This will tell  for sure if the pregnancy is viable or not.Also since you have a seizure disorder and taking medications for the same , you need to consult your neurologist and see if the seizure disorder is under control.It is very important that your medical condition is under control, do not stop taking the medication as seizures during pregnancy can have an adverse effect on the baby.You are also more likely to have a child with birth defect a slightly more chances about 35 more. So it is very important that you get regular scans and tests done to check for neural tube defects, heart defects .This risk can be decreased to a certain extent by taking high dose 5 mg folic acid.I would advise you to visit a neurologist and repeat the scan after 10 days before deciding on discontinuing the pregnancy.Hope this helps.Regards.