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
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Miscarriage/pregnancy loss
Suspected MMC at 9 weeks - the dreaded 2 week wait and what happens next
Lotty515 · 14/10/2017 15:39
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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[3].
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 
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