Q&A: No heartbeat...
I'm a 29-year-old mother to a two-year-old and when I was pregnant with my second baby, I could not hear the heartbeat. When I went for my second check-up at 20 weeks, the doctor told me that my baby had stopped growing at 17 weeks. But I had gone for a check-up at 17 weeks and she had never detected that. What caused it and how is it possible that she missed it? I am now concerned about how long I can wait to try for another baby.

Dr Bronwyn Moore (gynaecologist) answers:

So sorry to hear of your pregnancy loss. This is what is called a missed miscarriage (or abortion)- missed because you had no indication that there was a problem until you had a scan, and it was found that your baby had died in utero.

Common causes include placental problems with poor growth, cord accidents like true knots or the cord becoming entangled, infections or diabetes. There may also have been a congenital abnormaility in the baby. In many cases no cause is found.

It is probably best to wait at least three months before you try to fall pregnant to allow the uterus to heal. You should see your doctor before that to be examined, have a pap smear and discuss if there were any findings that suggested a cause for the foetal death.

There are many specific management recommendations for certain causes. Book early in your next pregnancy (around seven weeks) and ask for anomaly testing to look for abnormalities at 12 and 20 weeks.

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