AIBU to think my termination wasn't complete?

[newyearoldme]

Reposting here for traffic...

I had a medical (not surgical) termination at 8 weeks in mid January in hospital and having passed there and then the requisite amount of tissue etc to be allowed to go home, considered the matter closed. As you do. Completely expected to have post termination bleeding for a while afterwards and was told by hospital staff that if I passed "anything larger than a satsuma" in the next two weeks then I was to go back as there may be an infection. Was told that should all be fine after two/three weeks.

For the next three weeks I had some general bleeding but nothing more than what I would call a slightly heavy period but which also by the end of three weeks had pretty much tapered off to nothing. No clots, nothing concerning, no "satsumas", no pain, no flooding etc.

After a few days of nothing at all, all of a sudden when out and about in a restaurant one lunchtime (abroad, no less), I feel a leakage and thinking I've just peed myself, try to hold it in but can't. I get to the loo and discover that my trousers are dripping fresh red blood and there are some clots (walnut sized, not yet a satsuma...) on their way out. Cleaned myself up as much as possible but over the next hour, I collapsed in the restaurant and bled out a huge amount of blood and some very large clots (baking potato, not satsuma). I was taken to local hospital where - so I was told as I was so out of it by this time - I effectively gave birth to a cabbage sized placenta. This would have been 12 weeks.

The local hospital staff were horrified to hear that I had not been scanned after the termination by my own hospital in January. Despite a slight language barrier, my understanding is that their view was that the termination had only partially worked and that whilst the pregnancy had finished, it had not all made its way out.

They also told me that as there was so much 'retained matter' (lovely phrase) the body had effectively been fooled into thinking I was still pregnant and therefore kept producing placenta etc which is why there was so much which came out. These doctors classified it a "miscarriage and haemorrhage" rather than "post termination haemorrhage" as apparently there was so much tissue etc that it pretty much constituted a miscarriage rather than anything post intervention, iyswim.

I had surgery in that hospital to remove every last bit and was discharged the next day. Am still finding myself revisiting the restaurant scenario as it was pretty traumatic.

Can anyone with some professional knowledge shed some light and/or perspective on this for me please, if only to put my mind at rest? Did my UK hospital make a mistake by not scanning me? I know this sounds crazy but is it really possible that the termination only partially worked but then nature took its own course with whatever was left? Why would I have such a large placenta and so much blood loss if the pregnancy had been terminated 4 weeks previously? Is there actually quite a lot of matter and tissue even at 8 weeks or could this be extra stuff which had developed in the intervening 4 weeks?

My GP is writing to the UK hospital concerned and I'm going through PALS to express concerns, but my mind is all a bit of a mess at the moment about it all. The only thing which is keeping me sane when I have visions of the blood and the huge clots and flashes back to contractions and blood gushes on the floor of the restaurant is that at least I had decided to end this pregnancy myself and that at least it wasn't a situation in which I was expecting a live baby later in the summer.

If you can help then I'd be most grateful. As you can see from the time I'm writing this, it's something that does keep my thoughts busy in the small hours.

You poor thing

Medical terminations have a relatively high failure rate 1-2/100. This is something you would have been counselled on.

It is not standard practice to ask you to have an ultrasound post termination either. It is usual to take a pregnancy test at a later agreed date, and to be asked to contact your original care provider if the test is positive.

I'm short, no mispractice from what you have said, it just seems like you were unfortunate in your experience.

I can’t help with advice but just wanted to say it sounds like a pretty traumatic experience and I’m sorry you had to go through that.

Hope you get some answers and feel better soon

Oh you poor thing. I am so sorry you have been through this new. it sounds like you may have ptsd so I would look into counselling.

They dont tend to scan after unless you get the wrong kind of bleeding. I miscarried and had an erpc which is the same operation, i had very heavy clotty bleeding and was warned if clots were bigger than 50p then call up or if i soaked a pad an hour. I would contact PALS definetly.

Not a medical view, but I had a miscarriage at 8 weeks last year. I was due to have the surgical termination but the miscarriage occurred naturally the weekend before. I went to my appointment and was scanned - they said that everything had passed except for a blood clot which was around my cervix and the would pass naturally in the next few days.

Then had a similar experience to you, although only a few days later. Away in the Lake District and suddenly started passing lots of blood and tissue in a pub toilet. Managed to make it back to the hotel but then had more bleeding and ended up collapsing and being admitted to hospital for a couple of days as iron levels were so low.

They said the same thing - that my body knew the clot was there so carried on as if I was pregnant, but I’m quite certain (and I think you’ll be told the same) that the pregnancy had ended at 8 weeks.

Not sure how helpful this is to you, but I guess just wanted to say that even if they had scanned you this still could’ve happened, as I was scanned.

Thank you Hibble - I think that's the rational view I need to take on this. I don't however recall any information pre intervention which discussed the relative failure rate, only that the nurse told me just before I went home to do a pregnancy test in four weeks "as it's extremely rare indeed but sometimes we need to repeat the procedure". Had the haemorrhaging not happened then I'd have done the test once I got back from my trip abroad.

It is unfortunately the way things are managed in the UK. A lot of money is saved avoiding scans, which may not be necessary in most cases, but as your case proves, not doing the scans can put a very small number of women at risk and whether this number of cases is tiny doesn’t remove the fact that those affected may find themselves in very traumatic situations like yours or in much more serious health problems.

Yes Pilates I think it's just kind of hitting my consciousness now. When I got back from my (work) trip I went straight back to work and have been on survival mode since then with kids, work and everything. I think a few cabin fevery snow days have now brought it all to the surface. GP seemed concerned but not surprised, so I guess this is perhaps a little more common than I had thought. Thank you for your kind words though.

I’ve had the same procedure as you, although sadly mine was for a missed miscarriage.
I had 2 rounds of the pills almost a week apart and both were unsuccessful.
After the first course of treatment, I was sent home (this was fine, I knew the treatment had failed) but 4 days later I ended up back in hospital where I had a very scary, bloody incident in a loo there.
I then had the second failed round of treatment. The remaining pregnancy was removed ‘manually’ by a doctor.
I was never rescanned though, just told to carry out a pregnancy test 2 weeks later which the hospital rang and checked I had done so and to make a note of that result.

Oh Fimble, so sorry to hear your story. Sending big hugs and love for an awful set of circumstances. These things do choose to arrive at the best times (usually in public) don't they??!

I was also advised medical termination will fail 1 in 10 woman.

Its shit new, it is. It does happen and it isnt surprising it is really affecting you. Do you have support around you? I would look into some kind of counselling or at least talking to someone about it.

I'm not looking to make a medical complaint, just to find some understanding about the situation. It seems that in the country I was in when it all happened it is standard practice to scan even after a medical termination and so they were quite surprised to find that it hadn't happened. Maybe though the info about failures needs to be beefed up a little...but then again maybe I did get given it but because at the time I was so fixed n getting the damn termination itself, I didn't pay proper attention. Then again, if you're in that situation, you probably don't want to hear that it might not work.

Bloody hell that sounds horrible poor you.
I know a few people whose medical terminations failed and they needed to go under to remove retained products of conception.
I don't know what to suggest but I think counselling would be a start.
So so sorry.

I had originally asked for a surgical termination as I had had problems a few years ago with a natural miscarriage which wouldn't come out (sorry) and associated trauma from the experience but was told in no uncertain terms that I wasn't going to get surgery as it wasn't 10 weeks, which I was told was the threshold.

I had the exact same thing OP except I had septicaemia by the time a friend carried me into hospital passed out. It seems to be more common than first thought. 🙁

Pilates - yes family v supportive and work also understanding. Had to tell them about it as was on work trip and their name came up in discussing insurance with the hospital to pay for my stay. DS is 18 months and doesn't sleep terribly well and therefore neither do I and it's thoughts of al this that keep me up in the night even after he's gone back to sleep.

Goodness me bumSquash - that sounds horrendous. Plus pretty horrendous that these procedures don't seem to work properly for quite a few of us. It's horrible enough to have to go through the decision to do it in the first place but if you then have to revisit it all a few weeks later with dreadful health risks then it's a wonder why the procedure hasn't been changed or improved. Not that I'm a medic, just someone who wouldn't want to wish this kind of experience on anyone.

I had a natural miscarriage at 13 weeks after my baby had died at 8 weeks. What I went through physically was identical to what you have described. My miscarriage had been diagnosed at a scan and the hospital refused to help me, telling me to go home and wait a week for a second scan. It was Christmas, they were running a skeleton staff and told and they couldn't do a d&c because they had to wait a week to see if the pregnancy continued to develop. They knew beyond all doubt it wouldn't so that was an excuse. I started bleeding in the interim and when I phoned the hospital.they were not interested. They told me to expect a heavy period and to get on with it. Like you, I bled for a week, very heavily. Kept thinking that 'This must be It'. It started to taper off and then I started getting waves of contraction pains. I thought I was going mad. In the early hours of the morning, I felt the urge to push and delivered my baby, placenta and collapsed amniotic sac in one. I did get an infection a few weeks after. I was utterly traumatised after, not just because I'd lost a much wanted baby, but because of what I'd been through physical. It was horrific. I'm so sorry that this has happened to you. Terminations are always traumatic but what you have been put through is cruel. Good luck with your PALS complaint. I was too traumatised to make one. Your gp should be able to refer you for counciling too if you feel you need it.

Sorry to hear about your awful experiences. I've had similar buy not exactly the same ...had surgical management for miscarriage (at what would have been just over 12 weeks). Hospital said it went well , was discharged and given advice to look for signs of infection etc, not scanned. Bled for about 5 days then had further discharge (not heavy for few more). Thought all had gone well. 3 weeks later out of nowhere (luckily had just got in from work so was at home) started passing huge clots and had really heavy bleeding. Lasted about 4 hours then stopped completely. Went docs next day who referred me back to EPU who scanned me and found what they called "retained products". Had to have further surgical management the next day. The sonogropher who scanned me said it was extremely rare for them to miss this much and was very apologetic . However upon waiting for surgery the next day I heard the surgeon speaking to 2 other ladies before me and gathered they were both having their second surgery too so not sure how rare it is or whether we were all unlucky and had the same initial surgeon or something. It was traumatic having to revisit it all and go through surgery again. Be kind to yourselves you've been through an awful time. I found the second surgery much harder to deal with than the first as I'd thought I was on the mend.
So not exactly the same experience but just wanted to let you know that my hospital didn't scan me after either surgery. They just assume all products have gone.

Lampshade - so sorry to read of your experiences too. It must have been a particularly distressing time and I hope you had some good support. It's shocking to realise that there seem to be so many who've gone through something similar. Strength and support in numbers, I say.

Gosh Jeds and Loki - so sorry to hear about your experiences too. Sending love, hugs and
I thought the point of a surgical termination was actually to physically remove all of the tissue in the first place, so that must have been particularly traumatic, not to mention bordering on the possibly negligent if other women had the same problem too.

Is the failure rate / subsequent health risks for medical terminations well documented do you know? Or is it something that really needs to be re-examined by NICE or whoever with the information that is given and steps taken?

Had miscarriages and had scans which were never helpful. They were more concerned with bloods or pregnancy tests.

In fact had a scan at 20 weeks and it was so inconclusive it shed no light on why I was bleeding so much.

I had a Missed miscarriage at about 16 weeks, pregnancy hadn't progressed since 8. I'd had some bleeding but was told it was implantation bleeding. Had bleeding again and did a scan. Heart beat found but somehow 4 weeks less than my dates so they backdated the pregnancy, even though I told them I didn't think k this was possible. Day before the '12' week scan I had heavy bleeding and was scanned and hadn't progressed. Advised it would be like a heavy period. Very heavy bleeding, if I moved from the loo it poured. Told on the phone I was probably shocked as I wasn't used to heavy periods. Clots increased in size to the size of a large potato. Afterwards I was very anaemic. Something obviously went wrong and somehow I was later than they predicted, baby didn't progress but everything else did. The contractions were as bad as when delivering my son.