Metanex Preventing Miscarriage?

Cynthia Flynn's picture
Experts: 

QUESTION

Dear Midwife,
Three years ago I got pregnant and then miscarried at 6 weeks. There was a lot of blood and a lot of cramping. When I went in to the doctor, he was very good about helping me through the ordeal and because of my father's medical history, decided to run some blood tests. I was diagnosed with MTHFR and prescribed Metanex. In September of that year, I became pregnant again and now have a beautiful boy that I love dearly.

Two and one half weeks weeks ago, I took a pregnancy test and found out I was pregnant again. The doctor that I currently have, did not believe in the Metanex, so he prescribed me with 1mg of folic acid and no prenatal pills.

On Saturday, I began to bleed. I bled "medium" Saturday and Sunday. Monday I went to the doctor and he did a pelvic exam stating that my cervix was still closed and I was "threatening" to have a miscarriage. We did an ultrasound and he drew blood, saying that I should come back in a week to check my hormone levels. He called last night, Tuesday, and stated that the hormone levels came back at 1, so I've had the miscarriage.

While I am not in denial to the fact that I could have miscarried, things aren't adding up. Granted this time I was only 5 weeks and last time I was 6 weeks. The process has been entirely different. The major bleeding has not been there, there has been no cramping, very little tissue passed, and the last time it took 2 weeks for my hormone levels to go down, not just a few days.

Do you think I should get a second opinion? I plan to request to be put back on Metanex, what are your thoughts about Metanex versus 1mg of folic acid?

ANSWER

Congratulations on the birth of your child, and I'm so sorry for your loss.

Unfortunately, my drug guide does not list Metanex, so I'm not exactly sure what it is.

As for your current situation, in order to have a positive pregnancy test, your level needed to be at least 10 (most tests use 25), so your level has clearly dropped. That being the case, I would agree with your provider that the miscarriage has happened. It sounds like it happened sooner this time, and that possibly the fetus did not form as well as before in the first place, so there was less to pass. In fact, the body can actually reabsorb the tiny ones without you being aware of much going on.

If you are still unsure, you can take another home pregnancy test in 2 weeks and if you were carrying a viable pregnancy, it would definitely be positive.

Again, I am so sorry for your loss.

-- Cynthia, CNM. PhD.