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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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Original poster

to expect A&E to scan me when I've miscarried?

24 replies

engelbart · 01/03/2009 08:55

My first post on MN, having very recently found the site. Didn't want to post this under "chat" as it's not a very chatty topic and didn't want to post in "miscarriage" in case I worry/upset other women going through this.

This isn't a post criticising the NHS or it's staff, but a genuine attempt to find out if I'm being unreasonable?

Was having a bath on Tuesday, stood up, and saw a huge blood clot, about the size of my hand. Didn't know what to do, so picked it up and flushed it down the toilet. I think I was in shock. My period was a few days late and I had been trying to conceive so I knew I was probably miscarrying. Told DH who said we should go to hospital but I didn't want to, I know enough about miscarriage to know that there's nothing anyone can do once it's happened. Had terrible stomach cramps and bleeding for a week with more clots coming out. On Saturday the pain was worse. I took a pregnancy test hoping it would be negative so that it would confirm I had passed the pregnancy and I didn't have any tissue retained (you can tell I've been reading the miscarriage board threads). The test was positive. Got quite upset at this point and because I was still bleeding DH persuaded me we should go to A&E.

Saw triage nurse at A&E and showed him the positive pregnancy test I'd taken an hour earlier, described symptons etc. He said it sounded like I had "expelled" the pregnancy and I was in a queue for a scan to double check. Saw another doctor who told me he needed some uring so he could check for pregnancy. He tested my urine thress times and apparently it was negative. He then said as it was negative I didn't need a scan and to go home. I asked if I could have a scan as I'd had a positive pregnancy test at home (showed him the stick) and he said the best he could do was get the early pregnancy unit to ring me next week to arrange for a scan.

I really do not want to have to go the early pregnancy unit. I'm pretty sure there can be no baby after the huge clots I've passed, but I am worried there may still be some tissue inside me which needs to come out. How long should I expect to bleed for? I would have preferred to have waited in A&E for as long as it took last night to have a scan and know for sure. DH and I are desperate to conceive again and I'm now worried that if I do get pregnant in the next few weeks a pregnancy test may still show positive because of the miscarriage, rather than a new pregnancy...

A friend had a miscarriage last year and she said they scanned her as a matter of course at her hospital which is what I assumed they would do for me. So am I being unreasonable?

OP posts:

mathsmummy27 · 01/03/2009 09:00

They should have booked you in for scan, you might need D and C. This happeened to my friend and she found out at the scan she had twins and only miscarried one.

Hope you are as ok as you can be.

mylifemykids · 01/03/2009 09:02

I'm not sure if YABU and can only go on my experience. I had bleeding at 8 weeks pg, was given an internal scan where 'baby' was only measuring 5 weeks and there was no heartbeat. I was told to go home and they'd rearrange a scan for 2 weeks time if I hadn't m/c by then. I miscarried that evening and, when I phoned them to tell them, they just said to phone them if I was still bleeding in 2 weeks and they'd scan to make sure there wasn't any tissue retained. I didn't need the scan.

Sorry for your loss xxx

newpup · 01/03/2009 09:05

I am afraid I have no knowledge about this but just wanted to say I am sorry. It sounds like a rotten experience. Do you have a sympathetic GP you could see tomorrow? They would be able to advise you and might be able to arrange a scan.

Hopefully somebody will be along soon with more knowledge than me. Hope you feel better soon.

spicemonster · 01/03/2009 09:06

Sorry you're going through this

TBH you'd be better off being seen by the EPU next week to make sure everything is passed as then you're in the right place if you need a D&C. If you were still bleeding when you went into A&E, they wouldn't be able to tell you if you've passed everything. You need to be scanned after the bleeding has stopped.

ANTagony · 01/03/2009 09:06

So sorry for you and your DH. I can understand you wanting to have a scan and have all the answers its such a shock to your physical and emotional system. If A & E are busy they need to prioritise and unfortunately it sounds as though there was nothing that could be done at this stage.

I had to have scans at the early pregnangy clinic and had big problems with heavy bleeding in early pregnancy. They are set up to deal with early pregnancy, are trained to answer your questions and can discuss all your concerns with you. They will also probably give you an internal scan which is far clearer than an external. It does sound like good advice that you've been reffered and should provide you with ongoing support rather than a quick external scan and out the door.

If you go, which I really think you should as you have questions, you will get support numbers and find out who your local midwives are so if in the future you have concerns you'll have someone to phone, who can pop round.

ChocEclair · 01/03/2009 09:06

engelbart - firstly so sorry you are going through this. It is not easy no matter how early it is.

From my own experience, it does sound like you prob have mc BUT the EPU should see you as they need to check there is nothing left (sorry if this upsets you). When I mc, it was only 8 weeks, but they did 2 scans, a week apart. The first to confirm mc had started and the 2nd to confirm everything was gone and no further action needed.

You might have to wait til Monday morning for the EPU - don't think that's unusual, but please go. It's not a case of BU or NBU - that's just the NHS.

Your pg test may still show +ve for a few weeks - don't think there's much you can do about that.

Hope I have helped a little xxxxxxxx

Ronaldinhio · 01/03/2009 09:17

YANBU because you are worried and upset. I'm sorry for your loss.

However after a few weeks of pregnancy there isn't really anything to scan for. Your positive test for pregnancy is HCG levels returning to normal.
If you are worried take the early pregnancy unit appointment. AFAIK they only do a d&c after 6 weeks of pregnancy.

Otherwise please take care of yourself and try not to get worked up by not getting the treatment you desired in A&E

Frasersmum123 · 01/03/2009 09:21

Sorry that you are going through this, its a horrid experience.

Are you in any pain?

I think they should have given you a scan just to check that you had passed everything, especially as they did not get to see what was passed.

I have suffered three M/C and although I though I had passed everything, I have always needed a D+C afterwards. However my M/C were later than yours seems to have been if you were only a few days late.

Im sorry I dont have any more advice, but I dont think YABU

Original poster

engelbart · 01/03/2009 09:30

Thanks for all your good wishes. It seems from what most people have said that it is not standard procedure for A&E to scan. I am confused about having to go to an early pregnancy unit if the pregnancy has passed. I could understand if I'd been bleeding but hadn't passed any clots but because I have passed such huge clots I'm pretty sure I'm not pregnant. I am really worried about having a D&C- I just want to put this behind me and start again. The bleeding has now stopped which I guess must be a good sign. I think I will take another pregnancy test later in the week and if it's negative will cancel any appointment I get for the EPU.

OP posts:

macdoodle · 01/03/2009 09:34

I am sorry too for your loss and of course YANBU for being confused and upset
However it is not standard for A+E to scan and would have been little point at that stage - a scan in EPAU a few days later (or even the next day) would be more appropriate as they can take the appropriate action, they are set up for follow up and treatment which A+E wouldnt be
The advice is not to TTC for a few cycles after a MC anyway

bruxeur · 01/03/2009 09:39

As macdoodle says - EPU is your "in" to acute gynae services, and tees up any further scans/appointments, or even an ERPC if you need one. I've also never heard of an A+E with in-house transvaginal scanning either...

mm22bys · 01/03/2009 10:15

I am sorry for your loss.

I hope you can get to the EPU soon (I have no personal experience of this but from the other posts here it sounds like it is generally standard practice).

All the best,

mummytopebs · 01/03/2009 10:16

I had to mc's last year and got scanned at the epu, i found them very nice and sympathetic there and they seemed to know exactly what they were looking for. Had an internal and external scan to check no ectopic, twins etc. I think its quite normal to be sent to the epu. Sorry for your loss i know how scary it is. We want to try for another baby but v scared after 2mc,s, but we are going to try you cant let it put you off, i would maybe wait 3 month before trying again, cos they said to me wait just one period and then i mc again but this time mc at 10 wk so further on.

spicemonster · 01/03/2009 10:22

I don't know how pregnant you were but if the EPU call you for a scan, then I'd go to check everything has come away. But it's very unlikely there'd be anything left behind if you were very early.
Also I didn't have to have a D&C after my mc which happened at 13 weeks so there is a strong likelihood you won't have to have one.

Whether you get a positive pregnancy test or not has nothing to do with it. I wouldn't take a test if I were you - like Ronaldinho said, it might take a while for your HCG levels to return to normal and a positive test won't tell you anything I don't think and may just upset you more.

blueshoes · 01/03/2009 10:23

hi engelbart, I am really sorry for your loss. If your bleeding has stopped and you are otherwise well physically, I think in my very non-medically qualified way that you should be fine.

I had a miscarriage at around 7 weeks and passed what I was sure were the 'products of conception'. The scan showed I was in the process of miscarrying but it was not yet complete. I never went back to check that all products were expelled for the reasons I said above. I think it was what is called a natural miscarriage (rather than D&C).

My period resumed in the ordinary course.

If you feel unsure, do go back to EPU and explain you want a scan to be safe. EPU are used to this and will handle it a lot more sensitively.

Wish you all the best ttc.

Original poster

engelbart · 01/03/2009 11:09

I am so grateful for all the messages of support but so sorry to hear about everyone elses losses.

OP posts:

Liney15 · 01/03/2009 14:29

Hi englebart - I had a mmc after some bleeding last year and the epu unit was very sensitive.

Hope you feel better soon - its a really emotional time for you. Take care of yourself.

BONKERZ · 01/03/2009 14:49

i have had 2 MC, the first was at 6 weeks and i was kept in over night after going to A&E with bleeding and i was not scanned but my bleeding was monitered, i was scanned 4 days later at EPU and told i was indeed miscarrying, no intervention was necessary. My second miscarriage was at 14 weeks and i had just my scan which showed a heartbeat, i started bleeding a week later and went to A&E who sent me home to rest, i was still bleeding 4 days later and went back to A&E who did finally agree to scan me and found my baby had died and i needed a D&C to remove the tissue (this is now referred to as an abortion on my notes which is quite hard to accept!)
My advice to you would be to go to EPU for a scan, chances are you wont need a D&C but a scan may help you move on.

vjg13 · 01/03/2009 15:02

Please keep your appointment at the EPU and have a scan, it is better to get this checked and get advice on trying again etc. You will be dealt with by experienced staff who are very used to this situation.

sayithowitis · 01/03/2009 15:12

When I had MC1, I had to wait a week for a scan to confirm MC and then had to wait to be booked in for D+C which was done on the same ward where they were doing the abortions. Not a nice experience.
MC2 was cared for by a different hospital and they couldn't have been more different. Scanned and D+C same day as I went with suspected MC. MC3 similar experience to no 2, but the scan showed I was still carrying one of the twins. Pregnance closely monitored and healthy DS1 was the result. This was many years ago and I know things have changed, but I wanted you to know that every hospital does things differently and that it can work out fine too. if I were you, I think I would go to EPU as they should at least be able to reassure you re future pregnancies. Good Luck

Sassybeast · 01/03/2009 15:14

Sorry for you loss. It's definatly better to be seen by experienced staff at an EPU who will be able to assess you properly. Waiting is horrible but as some of the others have mentioned, if things are straightforward, it's better to have a scan as the bleeding is easing off.

Jux · 01/03/2009 15:24

I miscarried twice before I managed to have dd. The second time I had been bleeding heavily for a week, and rang the doc just to see if I needed to take iron pills or something (utterly ignorant, me). I was dragged in and given a pg test which showed up so strongly positive that I was sent down to Casualty where they did another one - also strongly positive - and tried to keep me in overnight. After hanging about there for 5 hours, I had another test, which was still very strongy pos so then I had a scan. They didn't find anything, and some other test for ectopic pg; I persuaded them to let me go home, ectopic pg test was neg, and I bled for another week or so and then everything went back to normal. No D&C or anything.

thederkinsdame · 01/03/2009 20:41

I am so sorry to hear about your m/c. I would defo give the EPU a call. As others have said, you should have a scan to check things out.

A friend of mine has just had one too and she contacted the miscarriage association, who were really helpful and explained what she should do and gave her lots of emotional support, too.

HTH - let us know how you get on.

Original poster

engelbart · 02/03/2009 16:53

Thought I would give a quick update- got an appointment for scan this afternoon. Didn't realise I would have to go to the ante-natal/ultrasound department. It was a bit upsetting having to wait with other pregnant women especially as when I booked in the receptionist asked if I wanted to pay for photos . The sonographer couldn't see any retained tissue which I guess in one way is a good thing, though I'd spent all day fantasting that she'd find a heartbeat. She gave me a letter to give to my gp which I read, wish I hadn't as the letter said I had a luteal cyst on my ovary. Bit worried about what this is and whether it will stop me from getting pregnant again or whether it means I need surgery . Think I might post something in the health section.

Thanks again for everyone's support, I don't think I would have bothered going to the appointment if so many people hadn't stressed it was important I went.

OP posts:

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