to think early pregnancy scans should not be offered on the NHS

[nancydrewrocked]

OK I am prepared to be flamed but I couldn't help thinking this when I spoke to a friend recently. So tell me why I ABU.

Friend has just started ttc. No difficulties, no previous history. 2nd month of trying she gets a +ve the day her period is due. Two weeks later another scan no HB. Friend understandably very upset.

But I can't help thinking this would have been easier on her if the GP had gently told her to go home take it easy and then done a blood/pregnancy test in 2 weeks. It also strikes me as a enormous and unecessary cost, especially when many areas no longer offer routine 12 week or nuchal scans.

no. no-one is diagnosing early miscarriage. forget about that. they are trying to rule out ep and mp etc.

your doctors sound shite, btw, and unaware of protocols. not unsurprising, but shite nevertheless.

In the (full) circumstances that the OP described, I think a pregnacy test would have been a good first call and then a scan only if that remained positive. Pregnancy tests can stay positive for a long time after the pregnancy ends, but at if a pregnancy ends at 4 / 5 weeks, they should be negative within a few days. (Of couse, the exact timing will depend on how sensitive the PT is.).

One in three pregnancies end in miscarriage, many of these before a period is due. There is no need for medical intervention for many of these. We only know about the pregnancies because tests have become so sensitive. I'm not sure medicalising these very common situations are always helpful.

YABVU there have already been cutbacks at my local hospital. I have had several early and late miscarriages and bleed in all my pregnancies. It's a horrid time not knowing if you are M/C and the sooner you know the better. Scans should be offered with a history of M/C or fertility issues and also for bleeding. I had loads with mine. Most pregnancies I had scans at 5-6 weeks, 8 weeks and 10 weeks. Luckily my bereavement midwife managed to get me appointments because if you ring EPU they always fob you off and say wait till 12 weeks etc etc.

another point op has missed - dates are not certain. a first scan round here is done 8=-10 weeks as dating is more accurate then....

they actually changed this quite recently down from 12 weeks.

Completely agree with the OP. And I have had several miscarriages, quite far a long.

Is the bottom line then that early miscarriage (before 6 weeks) can and should only be diagnosed by a scan?

Umm, yes! For one, it is perfectly possible to bleed and maybe lose an embryo but hold onto another.

It is also important to check that the uterus is properly empty.

To not seek a scan is madness, imo.

VVVU
Another 'survivor' of an ectopic here. Totally crazy attitude - fear of making too much of things, fear of overreacting, etc in these sorts of situations can kill.

OP I assume you've never had any difficulties with pregnancy. Either that or you are totally out of touch with what it does to a person to lose a baby or babies.

I had a pregnancy of unknown origin earlier this year, and it took months to resolve. they still dont' really know what happened.

I was in tremendous pain and needed two scans and several examinations.

when I got pregnant again, I was petriefied it would be ectopic again, so I was offered two early scans - one at five ish weeks and one at 7 ish weeks.

I have just paid for a third as I would have waited til week 14 for my dating scan, and it has shown that the baby has passed away.

This years' events have driven me almost crazy, while going through them.

I pay for the NHS - why shouldn't I be re-assured for my own wellbeing and mental health?

Bonsoir have you read the thread?

oh, and i bled from 5w-21w when pg with ds. I had scans pretty much every 2 weeks, just in case. should I really have just accepted that "it was all over"?

I do agree that we know about very early pregnancy because the tests are now so sensitive but it's also because once you start actively trying you naturally test once your period is overdue - well I did!

That's how it works and just because the tests are so sensitive now doesn't mean it's wrong to test at that point - if that makes sense?

Neolara : "Pregnancy tests can stay positive for a long time after the pregnancy ends, but at if a pregnancy ends at 4 / 5 weeks, they should be negative within a few days."

Complete and utter nonsense. I've managed a +ve test 3 mo after an early mc. One that, I might add, I hadn't got an early scan for, as I knew it was too early.

Dueling I guess I was making the point that when I started bleeding heavily several days after a +ve test it would never have occurred to me that it wasn't a miscarriage.

Maybe if I had been 8 or 9 weeks but that early on that was just the assumption I made. I was fairly sure that was a common reaction. Clearly reading this thread it is not and there are obviously many many people who have heavy bleeds very early and go on to have sucessful pregnancies.

Perhaps in that case there is actually an argument for saying that all woman should be offered a scan as soon as they have got a +ve test.

And yes both my mc's were heavy bleeds the first was at about 8 weeks and I visited the Dr who took bloods and got a MW to speak to me who told me the nature of the bleeding I had described it was almost certainly a mc. I then had to wait for more blood tests but no scan was offered. My first was a bleed within days of my period being due so I didn't do anything about it.

I had 3 scans before 8 weeks with DS! I had a second ectopic pregnancy and they weren't keen to remove it whilst DS was still viable. As it happens my body re-absorbed it and everything was fine.

The flip side is that both me and DS could have died.

I'm all for early scans.

Well, you and the other women are lucky you didn't haveectopic or molar pregnancies. Look, most people who have smear tests don't have cancer. Is that a shocking waste of money too? It's a form of screening, and in a way more efficient, as it's not universal, but triggered by a bleed.

x-posts - mine was to Nancy.

and, with my ep i bled, was told by gp to "go away, rest, you are miscarrying" i retested a few days later and got a bfp, i was sure that everything would be alright.

With a persistent molar pg you'd get positive tests even after miscarrying the baby, as the mole produces the same hormone. A scan would show the mole too, if it had grown.

Habbibu... An excellent point!

"Perhaps in that case there is actually an argument for saying that all woman should be offered a scan as soon as they have got a +ve test"

not at all. IMO Would be a complete waste of time and money and resources. Most women who find themselves pregnant are offered a scan at 11 - 13 weeks as standard to check viability and date the pregnancy. I am surprised that you would suggest a woman with no adverse symptoms or signs should automatically be scanned at around 6 weeks when it's been clearly demonstrated here by most posters that in the particular case you use in your OP that there was an underlying problem (bleeding) which needed to be checked out for the health of the mother to be.

"And yes both my mc's were heavy bleeds the first was at about 8 weeks " my understanding is that if you get to 8 weeks then the risk of it being an ectopic is less as your embryo will have been large enough to rupture your tubes before then. The 6-7 weeks is critical when there is bleeding/pain.

Basically I think by 8 weeks you would most likely know if your pregnancy was ectopic. I am still surprised that you weren't offered some kind of scan and so maybe they were neglectful in your care or you were lucky not to have any complications leading to the need for a scan.

yes, more or less by 8 weeks it's a rarer ep that is still ticking along.

"OP I assume you've never had any difficulties with pregnancy. Either that or you are totally out of touch with what it does to a person to lose a baby or babies"

I have had many difficulties with pregnancy and know exactly what it is like to lose a baby which is exactly why I questioned putting my friend through the roller coaster scenario that she has experienced in the first place.

I have repeatedly made it clear that this is not about early scans where there are problematic syptoms and I have also made it clear that I have learned something about ectopic pregnancies and apologised, I thought graciously for being ill informed about the same.

I have also apologised for upsetting all those that I have upset and added my own experiences but since they are falling on deaf ears I have asked HQ to pull this thread because it is descending into nastiness and that was not my intention.

And molar pg, I hope, Nancy? Rare, but nasty in their own way.