Dr. Raut's Women's Hospital

I am Dr Mohan Raut. I am practising Gynaecology from last 27 years and partner of ICPRM, India's first Immunotherapy centre for patients of treatments with repeated miscarriages or IVF failure or Implantation failure.

Today I am going to talk on an interesting topic, Pregnancy as Nature's miracle and how Immunology plays an important role in pregnancy maintenance?

Our body has a defence mechanism for Immunology system which protects us from various diseases. So anything which is foreign to our body is not acceptable to our body and our body builds up and immunological response against that. This is how the bacteria viruses which are prone to enter our body are prevented by our immunological system. Even in case of transplant is done, suppose kidney transplant, our body will not accept any kidney. It has to be matched with our body, tissue match is important. In a transplant, the kidney is donated by blood relation which can be easily acceptable.

Now in pregnancy lets see what happens. In pregnancy, 50% is from the mother and 50% is from the father. Now the part which comes from father's body is a foreigner to mother's body. So practically, there should be a rejection of pregnancy, but it doesn't happen. Because normally, there are immunological mechanisms within mother's body which protect the pregnancy in the uterus. Now in some unfortunate women, these mechanisms don't react normally or they are abnormal and because of which mother's immunological system considers the pregnancy as foreign and builds up an immunological response against the pregnancy. This stops the growth of pregnancy and leads to miscarriage. Now depending upon on what stage this response becomes maximum, we can get maximum presentations;

• Like when the response is late, then there will be a pregnancy, then the growth will stop and leads to miscarriage.
• If it an early stage possible, then there will be only a pregnancy test positive. Nothing will be seen in sonography and there will be a biochemical pregnancy.
• Or if happens very early, before missing the periods, then it leads to implantation failure and infertility.

So this is called as Alloimmune problem, responsible for miscarriages. This problem can be diagnosed with certain tests and can be treated with the treatment called immunotherapy.

In my next video, I will tell that how we can diagnose various immunological problems and other causes of repeated miscarriages.

For more information, you can contact me on www.lybrate.com.

Thank you.

Hello I am Dr. Mohan Raut, a practicing gynecologist from last 27 years and partner of ICPRM, India's first immunotherapy Center for treatment of patients with repeated miscarriages, IVA failure, rod implantation failure.

Today I am going to discuss about various causes that lead to repeated miscarriages.

Miscarriage is a traumatic experience for a woman and when it happens repeatedly it can be devastating. The problem of repeated miscarriage is huge because it affects almost 1% of couples. So at any given moment the number of patients suffering from this problem is really high. There are five common causes of this problem, those are;

• Genetic factor-  In this case, there are chromosomal or genetic abnormalities in the pregnancy and because of which the fetus can't grow, leading to miscarriage.
• Structural problems-  Structural problem in uterus or the womb. Here there can be double uterus. There can be a curtain or septum within the uterus which leads to compromise in the space allowing pregnancy not to grow leading to miscarriage.
• Endocrine group-  The problem arises in conditions such as diabetes, mellitus, thyroid ( hypothyroidism or hyperthyroidism), a condition called as PCOD or polycystic ovarian disease. These can lead to repeated miscarriages 
• Infection-  Certain viral infections and infections like toxoplasma can infect the pregnancy leading to miscarriage.
• Autoimmune factor or autoimmune disorders- This includes formation of antibodies against mother's own group and conditions like anti-thyroid antibodies, or antibodies against for a phospholipid part of the mother's body. The conditions known as collagen disorders are responsible for this and lead to repeated miscarriages.

Now when all these factors are tested, it has been found that almost 50% of couples with repeated miscarriages show that all these tests are normal. Then what is the cause in these couples? And in these couples the cause is found to be called as alloimmune factor or there is immunological rejection of pregnancy by the mother.

Now what is this alloimmune problem and how pregnancy is nature's miracle? I will discuss these in my next video.

For more information you can contact me on www.lybrate.com. Thank you.

Treatment for Repeated Miscarriages and IVF Failure

Hello, I am Dr. Mohan Raut, practicing Gynecologist for last 20 years and partner of CPRM, India's first Immuno therapy center for treatment of patients with repeated miscarriages and IVF failure or implantation failure. Today I'm gonna discuss a unique treatment called Immuno therapy, that is, Lymphocyte Immunization Therapy which is a form of active immune therapy for patients who have repeated miscarriages or repeated IVF failure.

LIT or Lymphocyte Immunization Therapy uses the patient's husband's white cells called lymphocytes for the treatment. In this, once the LI immune factor is confirmed, we separate certain type of white blood cells called lymphocytes from husband's blood and they are injected into the wife by sub-cutaneous intravenous route. Once this injection is given then the couple is asked to wait for a period of four weeks and after that, they should make active attempts at pregnancy and over the next one year, she should conceive. This is a very safe procedure as it has no long term side effects and it is quite effective.

We have been doing this treatment for more than 20 years and it has helped more than 500 couples whom we have given this treatment. Apart from LIT, there are other forms of therapy which can be given and these are the use of intravenous immunoglobulins, use of Intra liquids, use of medicines like steroids and certain injections like low molecular weight restaurant. So, with this therapy, it has been possible to overcome the problem of repeated miscarriages especially when all other factors are normal because the reason is LI immune problem.

For more information, you can contact me on www.lybrate.com. Thank you.

Tests and Treatments for Multiple Miscarriages

I am doctor Mohan Routh, a practicing Gynecologist for last 27 years and partner of ICPRN Indias 1st Immuno therapy center for treatment of patients with repeated miscarriages and ivf or implantation failure.

Today I am going to discuss about various investigations that will help us to find out what is the cause in repeated cases of miscarriage. Now depending on different causes there are different investigations. When the problem is genetic there are test known as karyotype of the pregnancy which is aborted. It is same for the karyotype checkup that is the chromosomal pattern of the pregnancy is checked. Also karyotype or the chromosomal pattern of the parents are checked to find out if there is any genetic problem. For structural problem of the uterus there are tests like sonography, especially 3d sonography.

Then test like hysterosalpingogram which is an xray test, then procedures like laparoscopy and hysteroscopy which helps us to find out if there is any structural problem in the uterus. For detecting endocrine problems test for diabetes like fasting and post lunch blood sugar HBA1C, for thyroid problems T3 T4 TSH, for polycystic overine disease the fsch and lh level and sonography help us to clinge the diagnosis. For infections there are a series of test, known as torch titer. In this investigations are done for toxoplasma, rubella, cytomegalo virus, herpis etc and it helps us in the diagnosis of infections. For the auto immune problems there are different tests which include anti-nuclear anti bodies, ss dna test , antiphospholipid anti bodies, lupas anti coagulant, protein c and s, so these are the various tests which tells us about the auto immune problem.

Now if all these tests are normal then the factor that is responsible is allo-immune factor. For that we do certain more tests when all the tests so far are normal. And these tests are lymphocyte crossmatch, levels of natural killer cells in the peripheral blood and in the endometrium. A chemical called tnf alpha which is produced by the lymphocytes in the blood. So these tests help us to do diagnosis of allo-immune problems. Once the diagnosis is achieved the treatment can be given accordingly depending upon the positive tests. For allo-immune problem the treatment is immune-therapy or lymphocyte immunization therapy which is an active form of immune therapy which helps to get over this problem.

For more about lymphocyte immunization therapy I will talk in my next video. For more information you can contact me on www.lybrate.com Thank you!