Is it Common for Doctors to Overlook Abnormal Blood Test Results After a Miscarriage?
At 28 years old, standing 5'7" and weighing 145 pounds, I recently experienced a miscarriage and have no prior health concerns, apart from a suspected luteal phase defect that has never been investigated by my doctors. I don’t take any medications, occasionally enjoy 1-3 alcoholic drinks a week, and do not smoke or use drugs. Here’s what unfolded in my case: - During an ultrasound appointment at 7 weeks and 3 days into my pregnancy, a nurse practitioner (NP) confirmed that I was indeed pregnant. Following this, she ordered tests for my hCG and progesterone levels on that Friday. - Fast forward to Tuesday, after four days, and I hadn’t received my blood test results. I reached out to the clinic, where they informed me that the results should have been sent but weren't yet. They promptly sent over the report after my inquiry. - The results revealed a concerningly low progesterone level, which was below the bounds for both pregnant women and those in their luteal phase, measuring only 4.09 ng/mL. The indicated pregnancy reference range was noted as being between 5.16 and 18.56 ng/mL. - Later that same day, the NP reviewed my bloodwork and wrote a comment stating "Everything looks healthy!" - Shockingly, just four days later, I suffered a miscarriage. I recognize that progesterone levels can be variable when assessing the viability of a pregnancy, yet my results seemed alarmingly low. Various sources I consulted online indicated that such a level might suggest an impending miscarriage. I felt it would have been appropriate for my abnormal results, highlighted in bright red as "ABNORMAL," to be acknowledged. It’s also worth mentioning that while some healthcare providers may choose not to prescribe progesterone to maintain a pregnancy, this is a conversation I wished to have had as well. Additionally, I was surprised by the lack of mental health support following the miscarriage. There were no follow-up assessments or depression screening questionnaires provided by my obstetrician's office, which I found quite unexpected, especially considering it’s a prominent practice in Manhattan known for its large patient base. Shouldn’t there be a higher level of care in such situations?
Answers (1)
3/28/2025, 5:01:12 PM
OpenHealth AI
I'm truly sorry to hear about your miscarriage and the challenges you've faced in getting the appropriate care and support. Your concerns about the oversight of your blood test results and the subsequent lack of mental health support are valid and worth discussing.
Key Points:
- Importance of Lab Results: Low progesterone levels can be significant during early pregnancy and might suggest a risk for miscarriage.
- Communication and Follow-Up: It's crucial for healthcare providers to effectively communicate abnormal results and provide avenues for further discussion.
- Mental Health Support: Recognizing and addressing emotional impacts after a miscarriage is essential for recovery.
Explanation:
Your experience highlights potential gaps in communication between healthcare providers and patients, especially regarding critical blood test results. In early pregnancy, progesterone is vital for maintaining the pregnancy, and levels that fall outside the normal range warrant a thorough discussion between you and your healthcare provider, including possible interventions like progesterone supplementation. It's concerning that your low progesterone was not adequately addressed, given it could indicate complications.
Following a miscarriage, emotional support is equally important. It's common for many women to experience a range of emotions, and healthcare systems should ideally provide resources, such as counseling or mental health screenings, to support you through this time.
Next Steps:
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Document Your Concerns: Write down your experiences, including dates and specifics about your interactions with the healthcare team. This can help you articulate your concerns if you choose to address them with the clinic or seek further evaluation.
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Request a Follow-Up Appointment: Schedule a consultation with your healthcare provider (or a different provider if you feel comfortable) to discuss your experience, the implications of the low progesterone levels, and your concerns about the lack of communication.
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Seek Mental Health Support: Consider speaking with a mental health professional who specializes in grief or reproductive health to address any emotional distress you may be experiencing after your miscarriage.
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Investigate Your Health: If you are interested, you might want to pursue an evaluation for the suspected luteal phase defect, as understanding your reproductive health can help inform future pregnancies.
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Explore Support Groups: Look for miscarriage support groups in your area or online. Connecting with others who have gone through similar experiences can provide comfort and understanding.
Remember, you're not alone in this, and advocating for your health and emotional well-being is important. Please reach out if you need further guidance or support.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.