Missed miscarriage question (poss TMI request!)

[BlueCrane]

This morning I went for my first scan (I should've been 11 or 12 weeks tomorrow) I have had no spotting, bleeding or cramps but there was only a sac measuring 5-6 weeks and nothing in there...so an MMC. We've opted to let things take their natural course and I have another scan booked in for 10 days time. Has anyone any idea how soon things might happen, how much I might bleed, pain I might be in etc? (sorry poss TMI needed!) I would prefer to let it happen naturally rather than have the medical procedure but just trying to guage what I'm letting myself in for!

Although I have no experience with this, just wanted to say I'm so sorry to hear about your loss. Have you posted this in the miscarriage section? They (sadly) have experience with this and may be able to give you some good advice. Best wishes. xx

Thanks newmummy I couldn't find the MC section - will have another look.

Hi BlueCrane - you can find it here. www.mumsnet.com/Talk/miscarriage

Hi BlueCrane, so sorry for your loss ? didn't want to leave your post unanswered, but you might be better posting on the miscarriage board. The ladies there are lovely and were a massive support to me when I had a MMC last June.

FWIW I opted for an ERPC ? like you I didn't have much spotting/no cramps (baby stopped developing at 5 weeks, seen at a scan at 8 and then 10 weeks after a tiny amount of spotting). I figured that my body had already held on for 5 weeks too long and was showing no sign of ending the pregnancy on its own, so for me it was the best solution.

The op was nowhere near as scary as I thought ? I was in and out in 25mins, home a couple of hours after going down ? and the physical recovery was fine too. So please don't be worried if you find that you need an op after all. Quite a few women I know who have let nature take its course have ended up needing an op anyway as miscarriages don't always complete on their own.

Hopefully you're getting lots of support in the real world too? just be kind to yourself in the coming weeks/months and take all the help and cuddles you can get.

Blue I'm really sorry to hear that (remember you from the bus).

The same thing happened to me - almost exactly the same timings too.

I started spotting at 11 weeks, bleeding a few days later then a week later it started - bleeding got heavier, then clots, then was quite a lot of blood etc. I ended up having the procedure in the end as a clot got stuck in my cervix, and I lost a lot of blood as my body tried flushing it out. This made it quite painful (regular cramps) and difficult to cope! The procedure was fine - I was out of it under general anaesthetic and woke up feeling physically better.

If I were you I'd stay at home and be prepared for a fair bit of blood loss but if at any point it becomes difficult or you start to feel dizzy etc then call an ambulance or go to a&e

So sorry BlueCrane. I get the impression they are all different, even for the same woman going through multiple mcs, but I went through something v. similar to you (in terms of dates) 3 months ago. Someone on here did say that apparently it's common for things to happen of their own accord at around the 12 week mark so if that's the case, you might not have much longer to wait (my dates were weird but I reckon I was 11 or 12 max when mine finally happened).

In my case, I had about a week of increasingly heavy spotting/red wipes/brown blood in knickers, then things really kicked off overnight one night, without much real warning (was booked in for an ERPC the following week). It was pretty gruesome for about 4 hours (I was filling about a pad an hour and passing clots on the loo), then bled fairly heavily for another day or so. The bleeding then tapered off over the course of the next week.

It is horrible to reach the end of the first trimester only to find it was all for nothing, but knowing I only had a sac to pass made the prospect a bit less daunting. Unfortunately that didn't necessarily mean the miscarriage was much lighter than more advanced pregnancies.

Blue I'm so very sorry.

I had a mmc in Jan. Found out at a scan at 10+1 after the tiniest pink tinge to my discharge. Baby measured 7 weeks with no hb. I went for an erpc too. I found out on the Friday and had the erpc on the following Tuesday. I had started to have brown discharge and a bit of bleeding though, but nothing much. I did wonder after if maybe that was because I'd accepted it in my head, and therefore kind of jogged my body a bit. Daft but maybe you'll get what I'm getting at!

Take all the help and support you possibly can. Thinking of you.

Thanks everyone for your reponses...I've also found the miscarriage forum (not sure brain functioning fully at the mo as totally missed it earlier!) iggly so sorry to hear of your loss too. I must admit the natural route is starting to sound a lot less attractive and will totally freak DH out as he's not good with blood (not that he will have to see any of this hopefully) but i'm still not keen on the thought of an erpc either. Will have to see how it goes. ktay your comment about only having to pass the sac is actually a good thought as I'm not sure I could cope with the thought of anything more at the moment. Think it's all starting to sink in a bit more at the moment. Not sure what to do about work though as have just started a new project which I'm managing but this probably means I could end up needing to be off work for a bit in the next few weeks...what a mess it all is.

sorry you're going through this. After six weeks of your body not having done anything about it, I personally would want the ERPC. I've had two natural miscarriages (one later needing a follow on ERPC) and one straight ERPC and I found the medical procedure much less traumatic than the natural way.
the first natural time I had a really rough time, though that was my earliest miscarriage at only 7 weeks. I initially went into shock and had heavy bleeding over about three days. It was more than a week before I finished passing everything.
The second natural one was later, at 9 weeks, but actually almost painless after initial contractions - yet incredibly bloody with enormous clots every 10 minutes or so (sorry) for one night and also lasting more than a week before the last bits came out.
So I think it's hard to know how it will go.
best wishes whatever you decide.

Don't even think about work!! Just think about yourself, I think it takes a while to sink it tbh especially as you still feel preg. It's a cruel trick of mother nature I think .

My inability to cope with blood is what persuaded me to go for an erpc, also I wanted some control over when as I have a 4yr old dd. I'd never had an op before in my life and was worried about the ga, but it was the easiest thing tbh and I physically I recovered very quickly afterwards with only minimal bleeding.

Do what's right for you and what you feel comfortable with.

Easier said than done - sounds like your job is a bit more responsible than mine - but try not to worry about work too much. My mc happened at the worst possible time in that respect (big deadline following a v. quiet 3 months) but my manager was great about it. Legally this is pregnancy-related so the time off shouldn't count towards your absence record but make sure you take all the time you need as I believe you have to take it all in one 'stint' for that to remain the case.

I told my manager as soon as possible and worked from home during the run-up to the mc, not that I was particularly effective. I mainly spent that time doing handover notes to put my mind at rest that I wouldn't be leaving anyone in the lurch too much.

Try and make yourself the priority. FWIW I was fine to go back to work a week after the main event (so while still bleeding) but people vary, esp. in how it hits them emotionally.

What are your concerns about an ERPC? I have to admit I was concerned too but then had no choice (this happened last Nov BTW). But it was actually ok and I'd go for it again.

iggly I guess there's part of me that wants to be absolutely sure there's totally no way there's any sign of life before having an erpc (that might sound a bit extreme, might be part of my coping mechanism, not sure) also I'm not good with hospitals and have only had a general anesthetic once and cried all the way down to theatre that time (I was 23 and having my wisdom teeth out so no excuses really). DH and I need to chat it through some more, having done some research on MN I now feel as though I have a better grasp of the facts than I did when I left the hospital earlier as they didn't really indicate how much I might blees/how much pain/that I might be better staying at home rather than going in to work etc etc.

The scan should confirm things for you in that respect (ie if there's been no change in size/appearance of HB over the course of the next 10 days).

Do you have private medical insurance? AXA were willing to cover mine, not that it was needed in the end. The prospect of having my own room and picking my appointment time helped sway my decision, although I deliberately left a bit of leeway in case things started of their own accord. If you can go privately, you might not have to deal with such a clinical environment.

Thinking back, I actually went into work until the spotting started as I found getting back to business as usual helped me cope. My manager would have let me have the time off though.

Blue I completely understand. Just make sure you look after yourself and get help if things become unmanageable. I probably should have called an ambulance earlier than I did as wanted to manage it myself.

I'm so sorry Bluecrane. It's a horrible experience that sadly a lot of us have had to go through.

I would really recommend the ERPC. It's a really light anaesthetic they use and the operation only lasts about 15 minutes. Complications are rare. Like you, I was scared about the anaesthetic too and opted for a natural mc, bled extremely heavily and passed out on the toilet because some product had got stuck in my cervix and I went into shock with v. low blood pressure, was taken by ambulance to hospital and then had to have the ERPC anyway because it hadn't all cleared.

I'm sorry to tell you that 'scare story' and I appreciate it's the last thing you want to hear at this difficult time, but you have to remember that although the sac was 5-6 weeks in size (mine was 7 weeks and mc at 10 weeks), your womb lining etc may well have continued developing and there could be quite a lot to come out.

Please look after yourself, get some help and tlc from others if you can, and call your early pregnancy unit if you have any concerns.

Sorry to hear about your loss, BlueCrane. It's a devastating experience to get to the end of the first trimester only to realise the pregnancy is gone already before you even knew. It feels like your body has played a nasty trick on you. I would second the votes on here for an ERPC as it is the least physically painful method to deal with MMC. The choices on offer - natural, medical mgt or ERPC - are all crap, really, and no choice is an easy one to make but to me, ERPC is the lesser of the three evils as you are at least out cold for it.

My MMC last August was supposed to be an ERPC but it happened naturally by itself at 12 weeks before I made it to surgery. It was a real nightmare and I had to be rushed to hospital. Don't want to scare you either so won't go into details but save yourself a lot of unnecessary pain and go for the ERPC. That's my view anyway. Especially if your DH has a thing about blood then you're better off dealing with it in a hospital setting.

Sorry for your loss Blue, it's an awful thing to go through :(

My post may be a bit graphic so anyone who doesn't want to read it please skip ahead

I've had a mc at six weeks and a mmc at 15 weeks (baby was 13/14 weeks). The mc at six weeks was natural. I began spotting and went to hospital, opted to wait and see while waiting for scan appointment. It gradually got heavier and turned red and dark red, it was like a heavy period. About 2-3 days later I started to pass clots, some of them mid-sized, the majority were like period-type clots. On the fourth day I had some very sudden cramps, they lasted around 15-20 minutes and I passed a large clot with bits of greyish-blue in it, as soon as the clot passed the cramps stopped and within a few hours the bleeding slowed right down - it didn't stop but it was noticeably lighter. A scan confirmed that nearly everything was gone, there was just a small piece left and I was given the choice of what to do next. I opted to go home again so was given a follow-up appointment for two weeks later and some antibiotics to take as a preventative measure against infection. The piece of whatever it was passed a day later and the bleeding stopped entirely after another few days.

Miscarriage is no picnic but it honestly wasn't as horrific as I was expecting. One of the doctors was really pushing me to have an ERPC and it was the nurse who took me to one side and told me that a six week baby is very small and that it would be no worse than a heavy period, every method of treating miscarriage carries risks but the more intervention used the more the risk increases. She was right about the bleeding, it couldn't be confused with a period because it was more clots than a period (sorry, TMI) but it wasn't agony and it wasn't like some sort of blood bath - nighttime style sanitary towels handled it.

I had a list of warning signs and told if I had any of them I was to go straight to hospital - heavy bleeding soaking more than a pad an hour, severe pain, dizziness/fainting, fever or chills.

You need to do what you're comfortable with. If the ERPC is stressing you then there's no harm in waiting for nature to take it's course, you might still need an ERPC ultimately but it'll be a last resort rather than a first. When I had my mmc I had to have medical management, basically pills to end the pregnancy, I was in hospital as a day patient until everything passed and potentially could have been kept overnight or had to have surgery depending on the outcome, I had to sign a consent form and have risks explained and it was all so medicalised. I hate hospitals and I'm terrified of procedures, needles, and all of that, mainly I'm scared of not being in control. The night before the appointment I was virtually in hysterics because I was petrified. My natural mc took longer but it was a lot more peaceful because I was at home, in my own surroundings, and it was private. I also had more complications from the medical management, which is a whole other issue.

I really am sorry for your loss but please do what's right for you an consider your options carefully. Be kind to yourself xx

I am sorry for your sad loss. I had a mmc at 12 weeks(baby deceased at 9 weeks). I had also only had very very light bleeding(though previous losses). I was sent home and told to come back in a week if nothing happened.
Literally as soon as I got home and lay down I felt a pop and waters broke. Then started bleeding quite heavily. I passed lots of clots(was told to take anything "identifiable" back to hosp as I previously had an abnormal pregnancy). Tbh I didnt find it that bad-period like cramps etc but I thought it was preferable to an erpc(which I have also had). Hope everything works out for you.

Thank you all so much for your responses and sharing what is a very personal and difficult experience. It has been very helpful to get a fuller grasp of what I might be in store for in the next few weeks and help me to prepare. I still don't have any pain, cramps or bleeding but DH and I have decided to wait for the scan on 7th June, hope that it passes naturally before then but if not we will review the option of an ERPC at that point. I am still trying to get hold of my boss but plan to give him 'worst case scenario' and say that I will be off for the next 2 weeks so that they get proper cover for my project sorted and then I have the space to work through all of this in my own time.

Bluecrane, so sorry for your loss. I echo what the others have said about being gentle on yourself and taking all the time you need. I carried on working through my MC and although the 'business as usual' approach helped me through the early days, I did find the phsychological sense of loss hit me later and harder than I expected. However, I just wanted to add my story in the hope that your MC progresses like mine did. I started spotting at 7 weeks, but the preganacy had stopped developing some time before that. It gradually got heavier and although it was a bit more uncomfy than a normal period and a bit heavier, with clots, it really wasn't as bad as I thought it would be. I was lucky in that I didn't have any complications, but I wanted to reassure you that some women are fortunate (if that's not an inappropriate word in the circumstances) that the physcial process of loss isn't too bad. I hope you are one of them. I wish you strength to come to terms with your loss and the very best of luck for an easy conception/pregnancy in future when/if you decide you are ready.

Hi Bluecrane
I'm so sorry this has happened.
I had a miscarriage at 11 weeks in October. I started spotting so went to EPU and scan showed sac but no fetal pole. They woudn't even discuss ERPC as said since I'd started it would carry on. Started bleeding properly the next day and four weeks later was still bleeding so finally convinced them to let me have an ERPC. Sorry to sound doom and gloom but just wanted you to be aware that it could go on a while and although the ERPC was scary it was all over with very quickly and the bleeding finally stopped 5 days later. I got my period 3 weeks later and conceived on that cycle - I'm now 27 weeks. Certainly for me I just wanted to get it over with asap.
xx

I had a huge breakthrough with my new and usually quite awkward boss yesterday who said he's just employed someone new for our team (been trying to get someone in for ages!) and they can start immediately and he's given them my project to do - he said he wasn't expecting to see me next week and that I should take my time...such a huge relief to know that is sorted!! Really thought last night was going to start it off but think my 'cramps' may have been in my head if that makes sense...will hang in for the next week and go for the ERPC if no movement before the scan on 7th. Got a day with very close friends today which will be nice and they only live just down the road so still v close to home if anything happens.