### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I have back pain, not sharp but continuous. also experiencing extreme fatigue and pain in my lower abdomen. also light pain on the left and right of my womb. I have had 4 miscarriages, the last one in April. Have had very regular period but are much lighter now since my last miscarriage

### output:

Hi, thanks for posting your concern in the Chat Doctor. A dull aching back pain along with pain in lower abdomen and a bad obstetric history warrants further evaluation to rule out underlying uterine or ovarian pathology or pelvic inflammatory disease and ectopic pregnancy. Before any other test, please have a urine pregnancy test done at the earliest. You should have a transvaginal ultrasound scan to rule out any ovarian or uterine pathology. Urinary tract infection or any other pathology should also be ruled out. Therefore, you should have a routine urine examination also. You should also have a KOH test of vaginal secretion. NAT is done to rule out other causative organisms of PID. A complete blood count with ESR, urea, creatinine tests should be done. You should also consult your local gynecologist for clinical examination and further management. In case you are diagnosed with any infection, appropriate antibiotic treatment will be needed. A USG of PUB should be done to rule out any renal, ureteric or bladder pathology. For the time being you should maintain good oral HY Chat Doctor.  Please also avoid unprotected intercourse. If your bowel habit is irregular, have spatula husk 2 SF in a cup of water at bedtime. For any further questions, please write back to me.