Natural vs Medical vs Surgical after mmc?

[Chocolatedays]

Hi all, I could do with some help.

Summary: slight bleed at 9weeks and EPU scan showed mmc at 7w 4d. Spotting has stopped and cramps are occasional and slight.

Can you share your experiences on the three options? (here the medical protocol is an oral pill then pess. 2 days later and cramping/ passing the sac etc at home)

Which would you opt for & why?

TIA

[Poohbearsmom]

Im sorry your going through this
i had some slight spotting and had a scan at 9wks which showed my baby had no heartbeat. I was booked to come for a scan to diagnose a week later but started cramping and bleeding heavily a few days later and the next day a lost my lo
from a pain point of view it was quite intense for an hour or so before i passed the sac but within half an hour that eased but i did feel a bit like i might passout before that, not helped prob by the fact i was home alone with my two little boys...
i went back to the hosp for my scan a couple of days later and they said my bleeding was a bit heavier then it should be and that i still had too much "products" and internal bleeding etc so they advised taking the tablets then re scan in a wk to see if i need a d&c... Well the tablets did not agree with me and im sure this is not what they normally do but they were bloody awful, all my pain/contractions were belly button up and into my chest they were horrid and instead of making my bleeding heavier which the doc said they would to "expell the products" they stopped my bleeding altogether! Iv only been spotting since other then one giant alot and am due back on thurs for scan but have been really unwell and went to g.p who took swabs and thinks iv an infection and has started me on antibiotics and thinks il be needing the d&c after all... So in the end of all this horribleness i may end up experiencing all 3
i could never have imagined id be here when i got my bfp
i dont think my experience is usual and i hope you get more helpful ppl along soon, im sorry your going through this and if you want to talk im here, take care xxx

[knackered76]

Sorry for your loss I had a mmc at just gone 8 wks, discovered at 10 week private scan. I opted for surgical as I figured my body had already held onto it for a couple of weeks and didn't want to wait. It's been 2 weeks since I had my erpc and despite the annoyance of the bleeding afterwards (not much, just annoying as it has only just started coming to an end!) I am glad I made the decision I did. Within a week my body started to return back to pre pregnancy and for me it helped to close that part of my life and move on. I did however have no signs of potentially miscarrying naturally. If it were to happen again I would opt for the same.

[MummyAbroad]

Hi Chocolatedays,

I'm sorry for your loss.

I had a medically managed miscarriage, it was long and drawn out, and two months later I had to have an ERPC so I'm not a good advert for the medical option.

I also had a mmc, with tiny bit of spotting.No cramps. My first ultrasound (at 14 weeks from last peiod) showed a 6 week old embryo and 10 week uterus.

I pessaries inserted in my uterus. It was like a really long, very uncomfortable smear test. (about 30 mins but feels like forever) I was told I would bleed heavily but never did, and had to go back for more treatment. In the end I had 7 rounds of pessaries, suction, oral tablets and injections all over the course of 2 months. Then finally the ERPC.

I should point out that I did all this abroad privately, and I requested that I wanted to avoid an ERPC unless it was medically very necessary. I think in the UK I would have been whipped in for an ERPC much earlier.

I am recovering from the ERPC now, all going well. I was bleeding heavily (like a heavy period) the first two days after, and now 9 days later its stopped. The reason I wanted to avoid an ERPC is that I had one two years ago after my son was born and then didnt have periods for about a year, I am not sure if the two things are connected, but I thought so at the time.

Let me know if you have any more questions, best wishes,

xxxxxxxxx

[going]

I would go for the surgical option.

I've had tow miscarriages both were natural but I hadn't been expecting one of them.

I had to have an ERPC after one which is not uncommon after a natural or medical mc. I wouldn't be able to face waiting and would go straight for the surgical.

[IzzyWizzyletsgetbusy]

I am so very sorry that you are going through this and having to make this decision

I had a MMC discovered at my 16 week appointment; the baby had died at around 14 weeks. I was given the option of surgery or induced medical management and opted for the ERPC. I was told that the medically managed route, at my stage, could be as or more painful than a "normal" labour and could last up to 24 hours. I'm telling you that not to scare you but quite the opposite - because they were factors that influenced my decision but I hope wouldn't apply to you. I also felt that after 3 weeks (I was theoretically 17 weeks on the day of the ERPC) my body was just not going to miscarry naturally.

I found the day of the surgery very stressful (had to wait until late afternoon) but physically it was fine and I don't regret my choice. The ERPC was a week ago today, I have had a few slight "twinges" but have not had to take any painkillers at all, the bleeding is down to brown spotting and I had a negative HPT this morning ( which I suspect precipitated today's fresh round of crying but which I know is physically a good thing at this stage). The procedure itself was very quick.

I think whichever decision you reach it's going to be difficult emotionally - sadly that's inevitable. Just try and choose whichever you think will be "easiest" for you to get through right now.

I will be thinking of you x

[Poohbearsmom]

Loopymumsy "it felt rude that i was so fine when i was still dying inside" oh hun ((hug))

[bosch]

So sorry that you're having to go through this.

I think the protocol here is natural, or maby that's just what I chose. I didn't want to medicalise the process if possible, I wanted to be at home and private.

Both mine were mmc, ie baby had been dead for a few days when I had the scan, no symptoms. First time, I did have to go in because I couldn't cope with the pain but once they'd given me an injection in my bum/leg, it went fine. Second time, I didn't need to go in and managed OK at home.

I got pg again after the first mc, +ve pg test four months aft mc I think. He's nearly 9. After second mc, I got +ve pg test within 8 weeks - he's 3 1/2.

Like others, I'd stress that it can (can) be quite easy to get over the physical symptoms but the emotional ones can take a while - I grieved for my first mc baby only after I mc the second. I found MN, and the MN pregnancy book which has a section on mc, to be very helpful. There's always someone here if you need to unload.

Best wishes to you, I hope it goes OK.

[randomimposter]

Sorry you're going through this.

Have had 2 MMCs, first one discovered at Nuchal Scan, baby had died a few days before. Recommended ERPC as baby big. Surgery and physical recovery was fine. Emotionally of course took longer.

Second time, I had a little bit of spotting so went to EPU at 11 weeks, baby had died at 9. Opted for ERPC again, but a 2 week delay for surgery. MC naturally in the meantime; at the time it felt quite scary as for 5 hours the blood loss was extreme, but pain always manageable. Then I could leave the bathroom and I bled for a further week or so, just like a period really.

Both surgery and natural were fine (had a quicker return to normal cycles after the 2nd MC, but that could have been due to acupuncture), have only heard medical can be painful.

Good luck. x

[Chocolatedays]

Thank you for responding. So sorry you have been through mmcs.
We are starting to accept it is nature's way of dealing with genetic issues, and having had a friend have to choose whether to terminate a severly malformed baby at 15weeks, I am grateful nature has decided it's not yet time for a second child for us.
Having a dd has helped beyond measure, for this I am deeply grateful.

Your experiences have helped me look at having an erpc. Thanks again.

[reallygrumpy]

Chocolate - I had an ERPC 2 weeks ago after a mmc and feel that it was the right decision for me. I was struggling to come to terms with having miscarried when my body still felt very 'pregnant' (nausea, tiredness, sore boobs etc) and feeling that I have my body back has helped me to move on. The only mistake I made was going back to work too soon out of a desire for life to be 'normal' again. If I was to have to go through it again I would give myself longer to recover. Take care

[Chocolatedays]

Thanks again - I'm booked in for Tuesday. I'm part anxious about the procedure and part relieved to physically move on.

Take care all of you.

[civil]

I went for the natural option and - the night after making that decisions - the tiny baby came out (about 10 weeks).

I wanted to experience that in the privacy of our home.

However, if it hadn't happened quickly, I think the advice was to have a ERPC.

Give yourself enough time to recover; my ds didn't and had many problems afterwards. A week or two off work might be needed.

[Chocolatedays]

So sorry Civil.
Had hoped it would happen naturally but no signs at all now - just still feel pg but know the baby is dead. Sigh.

The recovery time several of you mention - is that physical or mainly emotional?

[Chocolatedays]

Am I being overambitious hoping to drive for 2.5 hours just over 24hrs post Erpc?

[hubbahubster]

Hi Chocolatedays, so sorry you're going through this. Just wanted to add my experience ? v similar to yours, a little spotting at 9wks, not really worried, then the scan showed a MMC at 5+3. Rubbish The doctor tried to pressure me down the medical route, but I insisted on an ERPC. SOOO glad I did ? the thought of the op itself frightened me, but all that happened is I went to sleep, woke up and felt (physically) fine.

As for driving, you'll be really groggy and sleepy for at least a day, maybe two, after the op, so it could be dangerous. The issue is really more to do with going under than the op itself. I only bled lightly for four or five days and then was back to normal. I've had a few emotional (drunken!) sobbing sessions with DH, but it's now 6 weeks on and it feels a lifetime ago. With good family support you'll come out of this fine, I promise!

[LadyBee]

Hi Chocolatedays, I wrote an account of my ERPC on another thread (here), if you would find it helpful - I found it incredibly difficult going into it not knowing what was involved so hoped that this description would help others going through the same thing.
Sadly, I'm in the position of possibly needing to go through again myself, am waiting to see whether I mc naturally in the next few days. I think I've decided that if nothing happens by the end of this weekend I'll call and try to book something for next week.
I don't think I'd drive a significant distance so soon after the procedure. The effects of GA can be unpredictable. Is there an alternative?

BTW, if the link doesn't take you to the message it is dated: Wed 05-May-10 22:06:57

[Chocolatedays]

Thanks LadyBee. Why are compression stockings needed?

[KnitterNotTwitter]

Hi just adding my thoughts....

I've had a miscarriage confirmed today. I'm 13 weeks but baby hasn't grown much since 7 weeks

In that it's been in there for so long I've gone for the EPRC - I couldn't bear just waiting and waiting and not knowing when it was going to happen....

[LadyBee]

Chocolatedays I have no idea, I suppose they reduce the risk of blood clots somehow. I had to wear them for my c-section as well and that was with a spinal so I guess it's a surgery thing?

KnitterNT I'm so sorry - I was lurking on the feb AN thread as was due around the 16th, I saw you had some spotting but hadn't read any further. Really sorry to see that you had bad news.

[reallygrumpy]

Hi, compression stockings are to reduce the risk of deep vein thrombosis and some hospitals have started giving them to all patients coming in for an op.

knitter so sorry to hear your news. I hope your erpc goes ok. Mine was fine.

[Chocolatedays]

KNT - so sorry - I remember you from the AN thread - for me it is getting used to the lost dreams that hurts so.
Hope your erpc is ok.

Reallygrumpy - hope you are recovering speedily - physically at least.

Thanks LadyBee, Loosymumsy and everyone else. Sorry you have had to go through this too.

I feel so tired at the moment - I'm hoping the erpc will help shift my hormones and, before too long, restore my energy.