Suspected MMC at 9 weeks - the dreaded 2 week wait and what happens next(14 Posts)
A little advice/support needed please – I find these forums so supportive and open but have never posted myself so please bear with me I am new to emotional disclosure online!
I have suffered a suspected missed miscarriage at 9 +2 w, the scan showed a pregnancy sac but no fetal echo and no visible baby. The Dr said to come back in 2 weeks as I could have delayed ovulation and therefore not be so far along but I became pregnant using OVP kits and my periods are 28 days like clockwork so I am not feeling very optimistic though lovely friends have said to think positive until I know the final result.
I have a couple of questions I hope you ladies that have been unfortunate enough to have been through the process might be able to help me understand.
Fearing the worst how do they work out when your baby died?
Do you always MC naturally? I am still going to work and am carrying around maternity pads in case I start bleeding.
I have read people talking about blood tests for HCG – if the second scan doesn’t show a heartbeat will I be sent away pending the results of blood tests?
I understand from reading the miscarriage association website that national guidance advises hospitals to suggest natural management for two weeks before offering women other options. Is this two weeks from the second confirmation scan? I already feel pretty hopeless about my chances I am not sure I can cope with a further two week wait if nothing has happened naturally by this stage – has anyone else requested medical management at the confirmation scan and how did this go down with the medical staff? If they agree to medical management will this be offered that same day?
Sorry for the long post – thank you for reading
I'm sorry you're going through this, it's such a worrying time.
I had a scan at 7 weeks because I'd had some spotting and all was ok, I saw the heartbeat and was told not to worry. I went back the following week as I had more spotting but there was no heartbeat. They said there had been some growth since the week before so I assumed they worked out how many weeks I was based on the measurements of the embryo.
They discussed three options with me - the natural miscarriage, medically managed or surgical (can't remember what that procedure was called) I opted for the medical management and they made me an appointment for that afternoon. I didn't get the impression they had a preferred option, it was entirely my decision and I didn't feel pressurised into choosing one over the other.
I'm surprised you're having to wait another two weeks before getting a definite answer but I have read lots of different accounts of how different hospitals do things and they all seem to have their own policies.
I hope you are ok and have good support around you. Take care xxx
Thank you @sophieT83 and I am so sorry for your loss. I was told I had to wait 2 weeks because of the ultrasound waves and also to rule out delayed ovulation. My MV called me after I posted and confirmed as you said that I could have MM that same day. I am dreading having to wait with all the bumps in the waiting room.
I do have lots of support thank you my husband is amazing and I am very lucky to have lots of local friends. We are trying to carry on life as normal and do nice things.
I am currently wondering whether to tell my parents, we are due to see them next week and I think they will guess we are a little subdued but they are in their 80's and I don't want to cause them stress and worry xx
I'm sorry to hear you are going through this. I had very similar. Small bleed at 9 wks and scan showed what looked like a 5wk pregnancy with no hb which could be normal for that stage.
I was told to come back for a scan 2 wks later but may mc in that time. I didn't and convinced myself i would get good news at the second scan. Sadly i didn't.
My hospital were quite strong that they wanted me to mc naturally and sold all the benefits to me about how that was best so i went away for another week. For me i couldnt handle the wait and the unknown so i rang them after a week and they agreed to do medical management.
At my hospital you are giving the tablets to take at home so i waited until the weekend and did it. It was nowhere bad as qhat i expected but sadly it didnt work completely for me.
Won't go into details as i know my experience was rare but i did end up having an erpc which was amazing and i wished i had fought for that in the very beginning.
Due to my experience i now have it on my records that should anything similar happen i will go straight for erpc as that works best for me. I was lucky enough after my last mmc at 14+2 to get an erpc the next day.
Hi gingerbread mam thank you for sharing your experiences with me it means a lot. I am so sorry you have had to go through this twice. The waiting is so hard, we are keeping ourselves busy but there is just so much around to remind us of the impending scan. I wish you all the best for the future x
I had a scan last week at 8+4 that showed an empty sac. I have to wait for a second scan next Thursday (9 days later) but they were very clear with me that an empty sac at this stage is bad news unless I could be 4 weeks off with my dates which of course I'm not as like you I use OPKs.
Im really sorry but I would prepare yourself for bad news. I think it's mean of them not to have been clearer with you about what's going on.
I am in the same boat of waiting to miscarry but I feel more pregnant each day and the EPU said to me that a lot of missed miscarriages continue until 12 weeks. If I get to Thursday with nothing happening I'm going to ask for medical management as I am struggling with the waiting.
i think i shoulď have been about 14 weeks by the time it was dealt with. It's far too long when they had a good idea at 9 wks.
Your gp or the hospital should be able to do 48hour hcg blood tests. Nobody seems to offer them as standard but you could ask.
Wouldn't be conclusive but would be a good indicator.
Very sorry for you both.
A scan in a week should give you a definitive answer but you are completely right - expecting the worst is the way to go. The amount of time they ask you to wait depends on the diameter of the gestational sac but in the same situation as you, I 'only' had to wait a week and then had surgical management the very next day. I already knew the pregnancy was doomed as I'd had beta hcg values that weren't doubling and started to decline.
If you're finding the waiting extremely hard, I would consider ringing up and asking to be seen after a week. The guidelines state the following:
1.4.9 If the mean gestational sac diameter is less than 25.0 mm with a transvaginal ultrasound scan and there is no visible fetal pole, perform a second scan a minimum of 7 days after the first before making a diagnosis. Further scans may be needed before a diagnosis can be made.
1.4.10 If the mean gestational sac diameter is 25.0 mm or more using a transvaginal ultrasound scan and there is no visible fetal pole:
seek a second opinion on the viability of the pregnancy and/or
perform a second scan a minimum of 7 days after the first before making a diagnosis.
The guidelines can be found at www.nice.org.uk/guidance/CG154/chapter/1-Recommendations#diagnosis-of-viable-intrauterine-pregnancy-and-of-ectopic-pregnancy
Some change should have occurred over a 7 day period of time.
As regards treatment, they cannot refuse you management and force you to wait it out. The guidelines say (relevant bit bolded):
1.5.2 Use expectant management for 7–14 days as the first-line management strategy for women with a confirmed diagnosis of miscarriage. Explore management options other than expectant management if:
the woman is at increased risk of haemorrhage (for example, she is in the late first trimester) or
she has previous adverse and/or traumatic experience associated with pregnancy (for example, stillbirth, miscarriage or antepartum haemorrhage) or
she is at increased risk from the effects of haemorrhage (for example, if she has coagulopathies or is unable to have a blood transfusion) or
there is evidence of infection.
1.5.3 Offer medical management to women with a confirmed diagnosis of miscarriage if expectant management is not acceptable to the woman.
1.5.4 Explain what expectant management involves and that most women will need no further treatment. Also provide women with oral and written information about further treatment options.
1.5.5 Give all women undergoing expectant management of miscarriage oral and written information about what to expect throughout the process, advice on pain relief and where and when to get help in an emergency.
1.5.6 If the resolution of bleeding and pain indicate that the miscarriage has completed during 7–14 days of expectant management, advise the woman to take a urine pregnancy test after 3 weeks, and to return for individualised care if it is positive.
I'm so sorry this is happening to you. I've just had my 4th loss and it doesn't get any easier but the shock is much less great
Hi chunkymonkey123 so sorry you are in the same boat - I will be thinking of you on Thursday I hope it goes as well as it can in the circumstances x
Hi SVCT so sorry to hear that you have been through this 4 times, thank you for taking the time to share this info with me. I have read similar guidelines as well and my understanding is to avoid having to do repeat scans the hospital have a 2 week wait policy. Maybe there are other reasons - I am not sure I could handle 2 further scans to be honest so a 2 week wait is the lesser of two evils. I wish you all the best x
Hi Lotty, I hope you're doing well.
I went for my scan today expecting to be given/arrange some kind of management but unfortunately the sac had grown but it is still empty. As it has grown but is not yet above 25mm they said I have to have another scan in a week and I am booked in for medical management/surgical the next day (I can decide the day before which I want). So that will be three weeks and three nhs scans. If it grows again they will need a doctor to sign off the procedure.
Very frustrating and disappointing after counting down until today but at least I didn't find out at my 12 week scan.
Hope you get better news xx
Hi chunkyMonkey123 I am so sorry you are having to wait another week and have another scan that must be heartbreaking. I hope you have been able to have some time with your partner this week and do nice things. We are at my parents for a friend's wedding nearby which is lovely - odd to be in my single bed again but being brought tea in bed and having meals made is so great.
Sending you hugs and positive thoughts - will your scan be the 26th? xx
Glad you're having a nice weekend, and I hope the wedding went well.
The earliest they would scan me is next Thursday but I'm away for the weekend so decided to have the scan on the 30th and the procedure on the 31st.
I'm feeling ok about it now, any hope is gone so I'm just looking forward to being able to move on. The leaflet they gave me said either procedure won't affect your fertility and most one only have one missed miscarriage in their life so I'm hopeful about the future.
Let us know how your scan goes xx
Hi yes the wedding was lovely thank you. I felt a little emotional seeing the brides very pregnant bridesmaid walking down the aisle but everyone thought I was getting teery at the bride. Was def hard not to get on the wines too!
I hope you have a lovely weekend away and manage to rest, relax and enjoy it. I enjoyed this weekend much more than I thought I would so I hope can too.
I actually went to A and E today as I had some bleeding but as I've no clots or back pain they sent me away and said to keep my scan app on Friday. Now of course getting that faint glimmer of hope than maybe it will be ok - the human body is amazing but also rather cruel. I've no idea what to think.
I will keep you posted - be kind to yourselves x
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