Empty pregnancy sack at 8 weeks - what next?

[FiveandtheBonusBall]

I'm 8 weeks pregnant and today (following some spotting) had a private scan which confirmed an empty pregnancy sack (irregular shape) measuring about 6 weeks. I'd prefer to avoid any medical management really (though have had erpc in past after a mmc at 10 weeks so know it's an option). What I'm wondering is what to expect if I take the 'natural' route? Would there be less pain/bleeding as there's just a sack and no fetus seen etc, and how long should I expect to sit it out waiting for things to happen? Just light pinkish brown spotting at present. Thank-you x

[Irishmammybread]

Sorry to hear you're going through this Five.
I've had three natural miscarriages this year. The first started with spotting which progressed to bleeding over about 4 days, became very heavy with clots overnight and a scan at the EPU revealed baby had been passed but pregnancy tissue still remained, it took another 2 days before this passed.I was about 11 weeks at this stage but as I hadn't had a scan previously I dont know when development had stopped. It was quite painful and I was surprised how big the placenta was especially as the description of what to expect from the GP had been "like a heavy period" !
I then had a miscarriage at 6 weeks which was actually like a heavy ,more painful AF,when I was scanned a week later it was complete so it was all over quite quickly.
I got pregnant again straight away ,had scans at 7 and 8 weeks that showed heartbeat and normal growth, but at a 10 week scan I found out baby had died at 8w6d. Like you I wanted to avoid medical or surgical management if I could but it was actually another 2 weeks before I started to miscarry. When it happened I had mild cramps for a few days but no spotting and then suddenly started with a big gush of blood, I went on to lose the pregnancy within the next 48 hrs though bleeding continued for a further 2 weeks.
People seem to vary a lot with how quickly they go on to miscarry , my friend found out at the 12 week scan the foetus measured 6 weeks and she was showing no signs of miscarriage so she had an ERPC.
As you are spotting though it looks like something is happening, have you any further appointments for a rescan?
There is a very good thread on here somewhere about what to expect when you miscarry with helpful practical advice.
It is a very difficult time just waiting ,I know it all felt a bit surreal to me with my last MC when I found out initially as I still felt pregnant even though I knew baby had died, it all hit me harder once the miscarriage was over, look after yourself. x

[FiveandtheBonusBall]

Thank you Irish for telling me about your experiences - you've been through such a lot . I'm not sure what to do really. The bleeding has all but stopped and I'm worried that if it were going to come away naturally it would have by now (but see that it can take several weeks). I'm desperate to try again as soon as possible, so am going to make an appointment with my gp tomorrow and possibly get a referral to the epu. I want to avoid an erpc, but possibly medical management might be an option? Just concerned that any meds I take to speed things up might mean I have to delay ttc-ing . Feeling very numb today - horrible remembering when I woke up that I wasn't pregnant any more

[messtins]

Five I'm so sorry you are facing this decision. Medical management would not affect you TTC again straight away. I've had a natural MC at 10 weeks and more recently medical management at 8 weeks for retained products. Personally I found it painful and distressing, and having had the equivalent of an
ERPC after the birth of my son would choose that any day in order to have it all over with on a defined date. It's a very individual decision though. If you scroll down there was a recent thread asking whether to have a natural miscarriage or ERPC with lots of responses, which you may find helpful in making a decision.

[FiveandtheBonusBall]

Thanks . I've had a erpc before after a mmc at 10 weeks, and agree that is very much the simplest option. I would go for it in a shot but I'm worried about my cervix which isn't in great condition (there's hardly any of it left after lots of surgery for dodgy smears - in fact the consultant is surprised I haven't had problems carrying babies in the past (I have 5 dcs)). I'll see what they say tomorrow anyway. Feeling pretty awful (mentally) now. Keep on forgetting the mc and then remembering and feeling quite sad

[WeatherWitch]

Five - I've just been through a similar experience. I'd had brown spotting a bit from around 8 weeks and then had some heavier brown spotting for a couple of days around the 10 week point. This became slightly heavier with blood in it. It stopped overnight but I went for an EPU scan, which showed a sac measuring 6 weeks and 2 other possible sacs that hadn't developed. As I was 100% certain of dates they advised me that this was likely to miscarry naturally especially as I'd started brown spotting. I had some bleeding over the next couple of days then suddenly started to develop very severe abdominal pains. Got myself home somehow and within a couple of hours was throwing up from uncontrollable pain and intermittently losing consciousness. Managed to call the doctor who was very helpful and sympathetic, sent some painkillers round but was very keen to keep me out of hospital if at all possible. By this time I was bleeding about the same amount as a heavy period with some large clots and jelly-like mucus.

The pain died down quite quickly about 5 hours after it began but returned (nowhere near as badly though) the next day. I then passed what was clearly the sac, following which I suddenly felt MUCH better. Now (3 days later) I'm bleeding about the same amount I'd expect with a normal to heavy period, and no pain. I've got another scan on Friday to check that everything has come away.

With hindsight I'm glad I opted not to have medical management but wish I'd been better informed about the physical process, as going through this on my own was pretty terrifying given the level of pain I was experiencing. However, I didn't have long to wait and I'm not sure I'd be keen to sit around for a couple of weeks. If you have a scan at the EPU they may be able to tell you if there are any signs of a bleed - they certainly could see some in my case.

So sorry to hear about this - fingers crossed for better news for you soon.

[FiveandtheBonusBall]

Thank you weatherwitch for taking the time to let me know your experience. It sound you've had it pretty tough and I'm very sorry for your loss . I'm a little further on now. GP referred me yesterday to EPU who saw me this morning. Up until then I'd only had brown spotting but this morning clots were literally falling out of me and soaked through a pair of jeans to the knee on way back from school run . Had my scan thinking all MUST be gone now, but no the sack still there, although very elongated and heading towards cervix...Nurse recommended sitting it out in light of the already heavy bleeding, and am booked in for a re-scan on Monday. In the meantime have been signed off work, and wondering what I should/not attempt in terms of getting out and about.. Not easy to take it easy with 5 dcs. I really hope things happen naturally now but am a little worried about the level of pain/bleeding to expect. Was the bleeding preceeding the sack coming out worse for you if you don't mind me asked?

[Irishmammybread]

Hi Five, just popping on quickly (while I'm doing tea... multitasking!) to say for me the bleeding was definitely worse before the sac actually passed, but the pain got worse just before passing it.As witch has said, not a lot of information on the physical process seems to be given by the medical professionals in advance, I found the description of "like period pains" quite euphemistic, for me I would describe it more like mild labour pains.
I would make sure you have a contingency plan for childcare/ school runs just in case and try to take it easy.
So sorry you're going through this.

[FiveandtheBonusBall]

Thank you Irish. I'm now thinking waiting it out was a bad idea. I expected that it would happen within a few days, but no more signs that anything is happening and the waiting is just awful. My body feels so useless - why could it push out a full-term baby in less than 6 hours but a 6cm sac is just waiting there and doing nothing? . Maybe I should have gone into work after all as blood loss is far less today, but there again as a teacher probably not the best scenario if it does all start .
Just one more question - do you think it's ok to use tampons rather than pads for the bleeding? I know they're a no-no after a mc but before the sac has come out would they be ok?

[messtins]

Sorry you are going through this. I agree it would be better if medical staff were more honest about what to expect. Bleeding tends to lessen once the sac has been passed. I was passing large clots and wasn't aware of the sac as seperate to them (at 8 weeks) so it's possible it has already gone. Do you have a rescan booked to check?
As far as I'm aware the advice to use pads is throughout the process

[messtins]

I had my DS2 in 2 hours and MC took 5 days, then another week of light bleeding

[Irishmammybread]

I was advised definitely pads rather than tampons due to the risk of infection.
I would personally stay off work for the moment, miscarriage really takes it's toll physically and emotionally.I've found after the miscarriage has actually happened the feelings of emptiness and loss can be almost overwhelming,I think your body goes into survival mode to get through the miscarriage and then it hits you.
I thought I could cope when I miscarried at 6 weeks because it was early and I worked the day it started but ended up fainting and had to be signed off .I've had faint and dizzy spells after this latest mc too and felt weak for a few weeks after,whether from blood loss or hormonal changes,I don't know .
Look after yourself x

[FiveandtheBonusBall]

Thanks Irish, messtins. Have a rescan booked for Monday, but bleeding is actually lighter than it was before the last scan (yesterday) when the sac was still visualised . Unless perhaps it's breaking down and coming out in small-ish clots?
I know I will feel quite hopeless when it's over, especially as I don't think I'll be ttc-ing again. Ttc-ing again was a good focus after my last mc (which resulted in ds2) so will have to try and concentrate on what I have got, and not what wasn't meant to be x

[Irishmammybread]

I know exactly how you feel Five , we have three dc, ds 19y, dd1 13y,
dd2 8y.I'm 44 and the pregnancy that resulted in the first miscarriage was a surprise (we thought we were a bit past it!). We were thrilled and the kids were really excited so it was devastating to lose the baby , it affected the whole family and dd1 especially was very upset. I felt so empty after the loss and though I love my three dc dearly, it doesn't stop you missing, and longing for, the one you've lost. DH was keen to try again,not to replace what we'd lost, but we now really felt there was room in our lives for another child.
Having had two more consecutive miscarriages we're now wondering if we should continue. I can't get a referral for any investigation due to my age and the fact that we have three dc though I have been told by the consultant that it's worth taking aspirin and trying again.
I still feel I would regret more not trying than risking another loss, though I have to consider the effect on the rest of the family too.DH has more reservations, it's heartbreaking making babies and losing them We managed to keep the second two miscarriages from the younger kids luckily.
I know what you mean about ttc being a good focus to recover, that's how I felt too and I worry now how I'll cope if it dosn't happen. I'll have to find some way to come to terms with the losses. I know I'm lucky to have a wonderful family, and I think this has made me appreciate them more than ever .

[FiveandtheBonusBall]

Thanks so much Irish. It does help to know that the things I'm feeling are totally normal and to be expected. Are you trying again at the moment? Have the younger dcs at home today (shame my sick note doesn't cover them ) which is actually helping as I have something to focus on other than the mc. Ds2 has a tummy bug so is being sick constantly which is not something I feel like dealing with, and really hope I don't get it! Would be the ultimate irony if I started throwing up, after praying for nausea these last few weeks.
Brought myself to cancel my nuchal at the fetal medical centre this morning. Had been booked in to the see man himself (Nicolaides) which I was oddly excited about . The receptionist was so lovely and asked if there was anything she could do to help, which was so touching. Had a good cry after.
Anyway, am rambling! Does help to do so on here as no-one knows in real life so having to put on the happy face with people. Thanks again x

[Irishmammybread]

Don't worry about rambling, here is a good place to do it! Do you have any friends in real life who you could talk to or who have been through pregnancy loss? I was surprised after my first miscarriage how many people have had a miscarriage ,it's a subject shrouded in mystery but so devastating and life changing when you go through it. I've found mumsnet a great source of information and support, I've only joined relatively recently.
How old are your children,did any of them know you were pregnant? It must be a distraction having the younger ones at home with you, hope Ds2 is over his bug soon though.
It must be distressing having to cancel appointments, luckily for me the midwives at the EPU cancelled everything for me each time.
I'm not sure if we are going to start trying again this month, I was told to wait till after my first AF(which has just finished) and from then take aspirin ,I've also been back on pregnacare conception since just after the miscarriage. I feel ready to try again so if DH is willing we'll see.... I'm not very optimistic though, I know chances of conception aren't good at my age.(Though I suppose 3 pregnancies in a 6 mth period defeats the odds, but I don't know if it'll happen again and if it does it's still a matter of staying pregnant!)
I don't know how old you are but there is a really good thread on the conception site "fantastic 40 +" with lots of ladies who've been through pregnancy loss, some people are ttc, others not, there are some inspirational stories, a lot of support and a few laughs and tears along the way,come and join if you want!

[FiveandtheBonusBall]

Thanks Irish, I might just take a look at that thread (just in to my 40s). I'll admit something quite odd...I didn't actually tell dh that I was pregnant as it wasn't a planned pregnancy (messed up with my mini pill) and he is under a lot of stress at the moment. Of course I would have, if it had been a viable pregnancy, but seeming at the mc rate is so high, I figured why stress him out more if it's going to end in mc anyway, so kept quiet until the 8 week scan I'd booked. So now I have to try and hide the mc too Feel very guilty as he's being lovely as I do (of course) look awful and am blaming a very heavy period Not my greatest moment I'll admit. Have been ok so far, but if I need to have medical management/erpc I'm not sure what I'll do . Certainly not taking away from my stress levels!
On the physical side, the bleeding is now very light, though still bright red. Do you think there's a possibility that it might be tapering off, even though I don't seem to have passed a sac or indeed anything at all really since the last scan?

[Irishmammybread]

Oh Five ,it must be so difficult for you going through this on your own.
I can see your point though, I've been thinking if I do get pregnant again, (even though DH would know it's a possibility), I would try not to tell him for as long as I could. He finds the whole emotional rollercoaster very stressful,the excitement and anticipation first and then the disappointment that follows, so I would like to try and spare him the worry. I tend to start showing quite quickly though because I'm quite small to begin with,so I don't know how well that would work out!
You've had the best of intentions not telling your DH if you wanted to avoid stress for him. Women can need D&C for different gynaecological problems so even if you needed surgical intervention would he need to know all the details? Even if you do tell him now I'm sure he'd see the reasons you had for not talking about it sooner, and even though he would be upset by the loss ,at least you have spared him going through having that hope and anticipation crushed.
I don't know if you will have much more to pass, my miscarriage at 6 weeks was very different to the later ones, there was nothing obviously recognisable as pregnancy tissue, just a lot of blood and clots and bleeding tapered off within a few days, after a week it was completely finished.
With the others the placenta was very obvious and quite solid though I didn't see the baby,must have come separately with blood and clots.(sorry if tmi!)
With MC 1 I had started with heavy bleeding in the early hours of a Thursday morning and it was Saturday night before I passed the placenta so it did take a while.
You could probably phone your EPU tomorrow to chat to one of the midwives, if they have your scan details they might be better able to let you know what to expect?

[Brycie]

I'm so sorry for you, that's all, I'm glad you have good advice here and I've nothing to add buy sympathy and strength for the coming days and weeks.

[Brycie]

Irish I've just read part of your reply, it's so sad. Women go through the mill, that's for sure. Wishing well for the future to you both.

[Irishmammybread]

Thanks Brycie

[FiveandtheBonusBall]

Thanks Brycie. Irish it helps to know you understand a little as to my not telling dh...reading back I was worried I had come across as a bit of a nutter I think I have come too far now to tell him the truth (I have already got a fibroids story in hand) and the only thing to be gained might be some relief for myself, but maybe more angst for him thinking back to the last few weeks. He has quite serious depression that he won 't acknowledge, and is (thankfully) very self absorbed at the moment which is working well for now. As I am I suppose! Interesting to hear about your 6 wk mc - thanks so much for sharing, must be hard I am hoping as the sac didn't really grow beyond 6 weeks that maybe I will get away lightly. Tbh, if it wasn't for the scan showing the sac still there a few days ago I would have thought the worse of it was over. ONly a few days now until the scan though, so at least I will know what's going on then. For me, not knowing is def the worst thing.
Really wish you all the luck in the world if/when you decide to ttc again. Having 5 dcs already, I do know what it feels like when the prospect of another was raised and then so sadly taken away, though it is some comfort to give my children a cuddle and reflect on how lucky I am.

[Irishmammybread]

Hi Five ,hope you got through the weekend and the scan goes ok for you tomorrow.

[FiveandtheBonusBall]

Thanks Irish . Well to conclude the story, the scan today showed that everything was clear, so no need to proceed with the dreaded medical management. Goodness knows where the sac went, but it's gone! Nurse thinks it must have disintegrated, as my bleeding had been quite light since the last scan when it was still there. Apparently they see this quite a lot - might be useful for people to know that the sac doesn't always come out intact, and I had no pain and cramps at all. I feel I got off pretty lightly!
Back to work tomorrow. I feel like hibernating under the duvet for a week, but I know that I'll do better getting back to my usual routine than moping at home (not that there's anything wrong with that option!)
Thanks for everyone's support, esp you Irish; you've been a star! I really hope you get your bfp and have a very uneventful pregnancy soon xxx

[Irishmammybread]

Glad to hear you're physically getting back to normal and didn't need any intervention. Hope your day back at work went ok today, it's hard going back but it is a distraction and helps keep your mind off things, at least for a while.
The next few weeks and months will still be hard from you, esp if nobody knows in real life, come over to the 40+ thread if you feel you need a bit of support from people who've been through the same and understand the dilemmas of deciding to ttc or not! x