ERPC or Medically managed - Which method would you choose and why?

[iggypiggy]

Hi all,

It might seem a bit premature posting to this forum - but I was given the news at an early scan last week (7 + 4) that the baby had a very slow heartbeat and was only measuring 6 + 4. Since the scan all of my PG symptoms have gradually disappeared and I just don't 'feel' pregnant any more, I also started some spotting which has been on and off all week - so have prepared myself for the worst

So I was just wondering - if you haven't miscarried naturally - and have to have one of the ERPC or Medically managed options - which would you choose and why? And would the ERPC affect your chance of concieveing in the future? Sorry - just want to be prepared when I have scan tomorrow as I know I will have to make a decision

thanks xx

[EldonAve]

Sorry to hear you are going through this

I would choose ERPC as I have issues with bleeding and clotting.

Medical management (if your hosp offer it) will be fairly similar to natural mc but might start more quickly

[iggypiggy]

Thanks eldonAve v. helpful

I just read on a thread lower down that someone posted about Asherman's syndrome in relation to ERPC... am now worrying as I was thinking that I would opt for that option.

[EldonAve]

times article here

I think the risks are quite low, ERPC is not the same as D&C
Worth asking your hospital about though

[iggypiggy]

Oh really? I thought ERPC was the same as d&c? thanks v. much xx

[CMOTdibbler]

I'd choose ERPC - I've had two and one natural miscarriage, and the ERPC meant it was over and done with very quickly, and I didn't have to see anything.

I think the risk with suction ERPC of Ashermans is much lower than with D&C

[iggypiggy]

Thank CMOTdibbler - I had no idea they were not the same thing - feel better about that then. I kind of want it over and done with.

Am just so frightened of doing something which might affect my fertility for the future

ps. Love Terry Pratchett books

[mosschops30]

A friend of mine has just lost her baby at 8+2.
She has been offered either, but they recommended medical management.
With any surgical procedure you have to consider the risk of infection, and also the risks from GA.

[mumnosbest]

I had medical first but after a lot of pain it didn't work so I went for D&C anyway. It was over and done with quickly and had no lasting effects, a year later I was expecting my DD who is now a healthy 19 month old. Hope all goes as well as possible

[iggypiggy]

Thanks mosschops that's usefult to know - can imagine medical management might be more traumatic tho?

I have just been looking up ERPC and D&C and it seems they are the same thing? bit confused

[SesIsCountingdowntheweeks]

Sorry you're going through this.
I've had 2 missed mc and had an ERPC both times. In a funny way I felt more in control of what was happening that way.
Re conceiving again, I've been fine and am due 10th May! Hope you find that reassuring.
Thinking of you.

[iggypiggy]

Ses thanks - that's actually the sort of thing I was hoping to hear! Am so pleased you were aviable to concive ok after ERPC.

I kind of need it to be 'done with' - have spent last week crying every night and I just need to have it sorted. Am the sort of person that needs control - so it's the not knowing that has been killing me.

I just want to be sure I know as much as I can before having to make any choices.

[Nontoxic]

I've had 2 natural mcs and one ERPC (wasn't offered managed mc - never heard of it before).

What struck me was that, unpleasant though a natural mc is, it felt strange to wake up and 'know' the baby was gone rather than going through the whole process which, for me, seemed to help with grieving.

I was 12 wks at the time, whereas my previous mcs were at 9 and 6 wks, which is why the hospital suggested the ERPC would be better than letting nature run its course.

[iggypiggy]

nontoxic I had been hoping that it would happen naturally between the two scans... but is not looking like it will...

I have only heard about these options through reading posts on MN.

not sure actually what i will be offered...

[mumnosbest]

I think having the medical (taking the pill) does make you feel more in control. It made me feel like I was 'doing' something for my baby (sorry if that sounds silly). However for me it was very painful and distressing and I had to have the D&C anyway.

[LovelyPear]

hi iggy, so sorry you're going through this.

I'm like you - still waiting for my next scan and waiting to see if I m/c naturally before then. All 3 options we have are pretty grim, but like you I feel like an ERPC is the best option for me. I have until 14th to think about it.

I agree, it's the not knowing, and the waiting which is hardest to deal with. I hope that once you have made your decision you'll feel better.

The important thing is not to let anyone rush you, I'm sure if you need more time you can have another few days before making a decision. Thinking of you. x

[ruddynorah]

i had erpc after a missed miscarriage and would choose the same again if it were to happen. i have dd aged nearly 3 so didn't want the waiting around bit and all the aftermath. i had already carried the miscarriage for 4 weeks before a scan showed it had happened, so really just wanted it all gone and done IYSWIM.

i had no trouble afterwards. in fact it turned out to be a molar pregnancy so an erpc was really the best thing.

[Sawyer64]

Hi I had ERPC at 12 weeks for a blighted Ovum(ie.Sac growing,but no baby) I think people use the term D&C as most people understand that,whereas alot of people wouldn't know what a ERPC was.

Sometimes they do it in a similar way as a D&C,so might be best to talk to your surgeon if you can.

"Suction" is more commonly used for Terminations.IME

[iggypiggy]

lovelypear thanks for your message - so sorry you having this too. I think I want to make a decision quicky - cos I have a week off over easter - so can be away from work easily.

I guess there is a chance that things will happen naturally for you before 14th.xx

ruddynorah thanks is really good to hear expereinces.

Sawyer I think I will def take advice from Doctor. thanks x

[MmeLindt]

Sorry to hear what you are going through.

I am not sure about the difference between D&C and ERPC, I had my m/c abroad and the doc here said D&C so I think it was that and not a ERPC.

I have had 3 m/c and here in Switzerland/Germany most women have D&Cs (they are offered as standard) as there is a risk with a natural or medical managed miscarriage that it may be incomplete and you might need a D&C anyway to avoid an infection.

The standard statement here is that the dangers of an infection of the womb is too high to recommend natural m/c or medically managed. I was told that it can cause scarring making it more difficult to concieve.

As I say, this is the standard procedure here, and I had never heard of medically managed before I started posting on MN.

I can say that it took me 2 1/2 years to fall preganant the first time, and after the D&C I got pregnant right away. I have heard that this is not uncommon.

Good luck, whatever happens.

[MmeLindt]

Btw, I preferred the D&C anyway as it meant that it was done in a day, and I could recover and come to terms with it. I hated the thought of waiting for weeks to miscarry naturally.

[Sawyer64]

I had my ERPC in July 2005 and fell for DD2 in January 2006.

I was also 41.

It took a few months for periods to settle.

So I think we were trying from Sept -Jan (not too bad for an Oldie

[iggypiggy]

Thanks MmeLindt your input is much appreciated.

Sawyer64 thanks - that is good to hear I worry about my age alot (which will sound silly when you hear I am 33, but i can't help worrying!)

[Sawyer64]

Think thats natural iggypiggy.

Hope it all works out for you.

[LoneStranger]

Hi Igg-Pigg, sorry that you are having to go through this. Although so many have said this before me, each one of us wants to convey our own personal words of support and understanding and i'd like to add mine to that.

I just wanted to add that I have also been through both experiences. I woundnt 'advocate' one method over the other, as people's choices and circumstances are so different. I'd just say that the piece of advise I wish I'd been given is about the unpredicatbility of the on-set of m/c. I wont go into fuller details because anecdotal evidence is not 'scientific' and may be less helpful than intended.

Keeping you in my thoughts. Hope you are well informed and supported tomorrow. Please let us know how things go and how you are. x

[FattipuffsandThinnifers]

I'm so sorry if you have miscarried

ERPC is the same thing as D&C. I really don't want to alarm you about this, but I do have Ashermans syndrome. It was as a result of an ERPC.

As a result, I am a bit evangelical about people having as much information as possible about all the risks involed - but even so, I wouldn't ever advocate one method over another. Exactly as lonestranger said - it is just anecdotal evidence. The risks of Ashermans really are low. Thousands are carried out every week with no after effects.

The only thing I would say is that I have had both ERPC and two subsequent 'natural' miscarriages, and they were not that bad or traumatic physically. I would think the later the pregnancy is, the worse it is physically.

It might be an idea to have a chat with the dr at the scan tomorrow to get the full picture of both options.

Again, I am sorry for the situation you are in.