Gurgaon: Pooja’s journey to motherhood began with hope in early 2021, but soon turned into heartbreak after her first miscarriage. Despite emotional recovery, the couple faced a second miscarriage in mid-2022, followed by a third loss in late 2022, leaving them devastated and anxious about future pregnancies.
Clinically, recurrent pregnancy loss is defined as two or more consecutive miscarriages. Experiencing three pregnancy losses between 2021 and 2022 placed Pooja in the RPL category, warranting specialised care. RPL affects nearly 1–2% of couples, and in close to 50% of cases, identifiable and treatable medical causes are found.
After nearly a year of emotional and physical recovery, the couple sought specialised treatment in November 2023. A detailed evaluation revealed high blood pressure, hormonal imbalance, thrombophilia (a blood-clotting tendency), and insulin resistance, conditions known to increase the risk of miscarriage and pregnancy complications.
Following medical optimisation and counselling, the couple proceeded with in vitro fertilisation (IVF) under close supervision. The pregnancy was confirmed in early 2024 and closely monitored at Motherhood Hospital, Gurgaon, under the care of Dr. Preety Aggarwal, Medical Director – Obstetrics and Gynaecology, Motherhood Hospitals, Gurgaon. The early months progressed smoothly, offering cautious hope after years of uncertainty.
However, at around 31 weeks of gestation, her BP increased, and a routine ultrasound detected fetal growth restriction (FGR) and reduced blood flow to the baby. FGR affects nearly 5–10% of pregnancies and occurs when a baby does not grow at the expected rate in the womb, increasing the risk of fetal distress and preterm birth if not managed in time.
Recognising the risk, the medical team administered antenatal steroid injections to accelerate lung maturity and placed the mother under close monitoring. When early signs of fetal distress appeared, doctors made a planned decision to proceed with a caesarean section at 32.5 weeks of pregnancy (early eighth month) to ensure the safety of both mother and baby.
The preterm newborn was immediately shifted to the NICU for specialised care. The baby required respiratory support, temperature regulation, and assisted feeding, and remained in the NICU for approximately 18 days. Kangaroo Mother Care (skin-to-skin contact) was encouraged, helping stabilise breathing, promote weight gain, and strengthen mother–baby bonding.
With gradual improvement, the baby began accepting feeds independently and showed steady growth. Both mother and baby were discharged in stable condition and advised regular paediatric follow-ups, growth monitoring, and developmental assessments.
Commenting on the case, Dr. Preety Aggarwal said,
“Recurrent pregnancy loss is physically and emotionally exhausting for couples. This patient came to us with a history of three miscarriages and significant anxiety. Her evaluation revealed multiple medical risk factors, all of which required careful management. Close monitoring throughout pregnancy helped us identify complications early.
She added,
“At 31 weeks, fetal growth restriction and reduced blood flow indicated compromised nourishment. Timely steroids, continuous observation, and a planned preterm delivery ensured a safe outcome. Although the baby was born early, structured NICU care supported steady recovery.”
Sharing her experience, Pooja said,
“After losing three pregnancies, we were scared to hope again. When the doctors explained that my condition was recurrent pregnancy loss and that the causes were treatable, it gave us strength. Delivering early was frightening, but I trusted the medical team. Today, seeing my baby grow stronger every day feels like a miracle.”
The case highlights the importance of early evaluation even after a first miscarriage. While a single pregnancy loss may occur due to chance, timely assessment can identify hormonal and metabolic disorders before they lead to recurrent loss. Early diagnosis, planned conception, and specialised high-risk care can significantly improve outcomes, offering hope to couples facing similar challenges.
