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Which MC management is 'best'

(20 Posts)
BoyMeetsWorld Thu 13-Dec-12 20:47:27

Sorry...posting lots as going crazy.

I'd like advice please about MC management options. Although I am interested in personal experiences, I'd like any solid facts people know about out of expectant, medical or D&C which is safest & gentlest on your body. Also fertility implications for each. I'm not really bothered about the emotional aspect - fully prepared.

Iv searched for this info but nowhere seems to spell it put without a load of BS. Threads on here generally say to 'go for what is best for you' but I honestly have no idea & need to be prepared to fight for what I want.

Please help. (nearly 8 weeks btw if that matters)

Geekster Thu 13-Dec-12 21:15:29

I have had both a natural miscarriage and an ERPC. The natural one was horrible with lots of pain, clots and bleeding at nine weeks.The ERPC was over and done with in a day, with very little pain and bleeding. I think there are greater risks of damaging your womb with an ERPC as it is more invasive, but then you are probably at more risk of infection with a natural one as may not come away as easily. Neither one impacted on my fertility. If I had to choose again it would be ERPC every time. Sorry for your loss and hope I was of some help.

Jollyb Thu 13-Dec-12 21:20:42

Hi
I thought you might find this webpage helpful - there are a few links etc http://www.cks.nhs.uk/miscarriage/management/scenario_managing_confirmed_miscarriage/view_full_scenario. You could also have a look at the NICE guidelines as that will contain references.

Basically the advantages of expectant or medical management is that you can avoid an operation and the associated risks (anaesthetic, infection, uterine perforation and secondary adhesions). But the down side for both is that they take longer and there is always the risk that you will need surgery in the end if your miscarriage is incomplete.

I had an ERPC and it was very straightforward. I was relieved that everything was over quickly - I really didn't want my MC to last weeks. Interestingly my hospital doesn't offer medical management.

HumphreyCobbler Thu 13-Dec-12 21:24:47

I have had a medically managed and an ERPC. The medically managed one was painful and distressing. I was stuck in hospital and had to keep showing people what had come out of me. The ERPC was over quickly and I felt physically well afterwards in that I did not require any pain relief.

Sorry you are having to go through this.

Jollyb Thu 13-Dec-12 21:26:19

http://www.cks.nhs.uk/miscarriage/evidence/supporting_evidence/conservative_management

This page is quite helpful - it goes through the relative 'success' rates of each method.

Sorry to hear of what you're going through.

MrsJohnDeere Thu 13-Dec-12 21:52:35

I had an ERPC (MMC at 12 weeks) because once I knew that I'd miscarried I couldn't stand the thought of having a dead baby/foetus inside me, and I'm not great at uncertainty. With the ERPC I knew what would happen and when.

I'm so glad I did though because the histology results for the ERPC showed that I'd had a partial molar pregnancy and this could potentially be cancerous and needs monitoring for at least 6 months; there's no way I'd have known this if I'd taken the other options. BUT this is a very rare occurrence, and the chances A&E that it won't happen to you.

MrsJohnDeere Thu 13-Dec-12 21:54:14

Chances are blush - sorry predictive text

Welovecouscous Thu 13-Dec-12 22:02:21

Message withdrawn at poster's request.

BoyMeetsWorld Thu 13-Dec-12 22:02:28

Hmmm that NHS evidence doc basically shows there's no great prospects - the quickest, most successful option (surgery) has the highest risk to health whilst the least risky (waiting) is considered longer & more unpleasant - plus often results in surgery anyway so you effectively have to put yourself through both. Common sense would tell me to take the middle ground - medical - but that's the option I've heard the most horror stories about as an experience. So confused and don't know what to do.

My top 2 priorities from this are:
*not having to take time off work (or as little as possible) as I have no hol left & don't want to tell them about it
*not damaging my fertility as its very very important I can give DH a baby (long story).

And those 2 priorities seem to be conflicting factors - one requires speed, the other safety to fertility. No option offers both confused

lavender39 Thu 13-Dec-12 22:41:12

hi boymeetsworld

Altho i have no previous experience of this, im looking at going through the same thing, so very interested in the post...
Im 8 weeks and at my scan on monday they couldnt see any baby. Ive basically been told to go home and see what happens til next thursday, when ive another scan. I was offered the tablet option, but from reading some of the experiences of other people...i dont think this is the route i want to go down.
What people have been posting on here has helped me to make a decision, in that im going to ring the hospital tomorrow and see if they will agree to do a ERPC on monday.
I also cant afford to have much time off...and if it gets left til next thursday, im still going to be suffering at xmas.

I hope that you are able to come to a decision that works for you...i dont think ive had to ever make such a scary decision myself!

Take care x

stmalo Thu 13-Dec-12 22:45:12

hi - sorry to hear of your loss,
I've had both - erpc 14.5 weeks - I had no choice in this, it was an emergency. and natural at about 7-8 weeks, which was fine, followed by a scan to make sure that everything was clear.
To be honest I think both were fine, apparently my fertility is unaffected (though it would be nice to prove this with a full term pregnancy!)
Given the choice, before 10 weeks I would stick to natural - but i've only had the two.
Good luck xxx

ninjasquirrel Fri 14-Dec-12 07:57:27

I've just had a medical and it was much less painful than I thought - cramps for about an hour that weren't really too bad once I'd taken the hospital painkillers, then they stopped and shortly afterwards I went on the toilet and passed it I think. Quite heavy bleeding after that but no more cramps, and I spent most of the day cuddled on the sofa with DH watching TV. Just to let you know it's not always a horror story! Oh, and I was 12 weeks.

ninjasquirrel Fri 14-Dec-12 07:59:05

Just to add that I've not had the scan yet to check all is well but fingers crossed.

maillotjaune Fri 14-Dec-12 08:02:10

I could have written Geekster's post. Surgical management was such a relief after more than 2 weeks of wait and see. And a previous mc was incredibly painful even at only 6 weeks.

Bakingtins Fri 14-Dec-12 08:10:56

Hi boymeetsworld. I'm really sorry you are facing this decision. I've kind of experienced all three - natural MC at 10 weeks in 2009, medical MC this year at 8 weeks, and effectively an ERPC under after having my son and had retained placenta. The ERPC didn't have any of the emotional baggage but physically was pretty straightforward. I found the natural and medical miscarriage distressing and I ended up in hospital for heavy bleeding with both. I wasn't offered an ERPC because I was already bleeding but had retained products - I think they are trying to move towards medical management, but I would say this has more to do with costs that what is preferable for the woman.
Don't underestimate the emotional fall out of all this - I found at the time I went into a very cold and emotioless coping mode but it hit me later.
Hope you can make the right decision for you.

Blending Fri 14-Dec-12 08:13:40

I had an ERPC in Feb this year at 10 weeks. I waited a week after the mmc was detected to see if my body would deal with it naturally.

It was nearly painless from a physical side, and as far as I am aware from the research I did, there is no grater risk to fertility than with other choices.

There is obviously a minor risk with the general anaesthetic.

It was over in one day, no further scans needed to see if it had completed, and it allowed me to start the emotional as well as physical recovery.

Blending Fri 14-Dec-12 08:16:31

Oh and as you are concerned about the fertility side of things I'm now pregnant with twins so anecdotally I can say it didn't affect me x

Welovecouscous Fri 14-Dec-12 13:59:57

Message withdrawn at poster's request.

MammyKaz Fri 14-Dec-12 14:10:53

Boymeetsworld I'm really really sorry you're having to go through this. You've been given lots of information already but can I just say don't underestimate the emotional side of things. I know you say you're prepared but going through 3 mmcs were the toughest things I've ever had to do & get over. There are hormones to consider too.

ERPC for me is the quickest & as its such a common procedure sad is relatively safe. I now have a beautiful 2yr old daughter.

NotSpartacus Sat 15-Dec-12 09:21:13

Hi Boymeetsworld.

I am sorry you are going through this (I was due in July too).

I've just had an ERPC yesterday. It was fairly stressful and I got quite teary when they knocked me out. The hospital staff were very caring and made it as easy as they could. I can't say it was pleasant but it could have been worse. I bled quite a lot at the hospital but am only spotting so far today and pain has been minimal. I am going to take a couple of days off next week but if I really had to I could probably get back to my (desk) job more quickly. If you do a more physical job or have a hard commute you might need longer I would imagine.

I am worried about fertility too (especially as I only have one fallopian tube, and am knocking on) but I felt quicker was better as a week after the embryo died I was showing no signs of miscarrying. I couldn't bear to keep on waiting, especially as I still had some mild pregnancy symptoms.
And the hospital I went to use ultrasound guidance for the procedure so I hope any damage is minimal.
Incidentally, they didn't offer me a medical option. I doubt I would have taken it if it had been available as I had a medical treatment for ectopic once and it was not a good experience and really hurt. I know MC treatment is different, but I still would have wanted to avoid it if possible.

Whatever you decide, I hope it goes as smoothly for you as possible, and that you get your baby soon.

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