My sister's miscarriage - please help

[cazty1]

Hi. Any help would be really appreciated
My sister sadly had a miscarriage confirmed by private scan last Saturday. An NHS scan today reveals that not much of her womb content has come away and said she needs to return in a week's time for a further scan before deciding whether to go for a medical or surgical solution.
The problem is that we are due to fly out for a family holiday 2 weeks today which is the only thing keeping her going at the moment. With her not being able to move forwward for at least a week this is a problem. They have said that if she has the tablet then she should be able to go away if it works but if it does not work then she would have to have surgery and not go away. If she has surgery next week they have said she cannot go away and there is a samll risk of fertility probelms if the surgery goes wrong plus she cannot TTC again for 4 months.
My questions, if anyone can help me, are
Is there much chance of the situation reversing itself naturarally within the next week? To me it seems unlikely and I can't see why they are waiting a week for another scan which will probably show the same thing.
Does anyone know if you can go privately for a quicker solution?
Is it true that you have to wait 4 months to try again with surgery?
What are the chances of the tablet solution working and is it horrible?
Has anyone's fertility ever been affected by the surgery?
Any advice so that she can go on our long awaited holiday will be much appreciated.

I'd get her to ask these questions of her doctor. Because I don't know her situation. No there is no reason why you wait 4 months in general scenarios. Of course any surgery carries a risk but I don't know of anybody who has fertility issues following erpc (I had one and was day surgery, home within a couple of hours). But there might be factors I don't know about.

She might miscarry naturally, she might not. I think if she wants surgery she should request it. Some places will do it the following day. Can you go with her to help her push for what she needs?

I'm so sorry. It's a horrid time for her.

I'm sorry she's going through this, it's shitty enough when it's straightforward. And I can completely understand why the holiday is so important to her.

Do you know what her dates are? For example, I had a mc diagnosed at 11 weeks but the baby had died 5 weeks earlier, therefore the likelihood of things happening naturally was quite slim as they hadn't happened in 5 weeks.

The other thing is how sure is she of her dates? As I said above, the fact that there was such a discrepancy between what I was and what I should have been meant that I didn't have the second scan and went the surgical route within 3 days. No one mentioned not being able to travel although I suppose it is sensible to wait until you know for sure that any surgery has been totally successful.

There is no restriction on when you can try again. They main thing is that she has stopped bleeding completely. The medical profession like you to wait until after your first period but that is so that the next pregnancy is easier to date, no other reason. She can start trying as soon as she feels ready, bleeding permitting.

Others will be along soon with probably better advice.

Thanks SOH and GML. The baby died 5 or 6 weeks ago so that's a good point Gwen - it surely would have happened by now if it was going to.

Thanks for replying.

In that case I would ask for an ERPC as soon as possible. If she is absolutely totally sure of her dates and she is happy (not happy, you know what I mean) to continue then there doesn't seem to be much point in dragging it out. I'd certainly recommend that she talks to them again anyway.

Hi again, I gave her your advice to go back and request an earlier ERPC as the baby died 5-6 weeks ago and so will not come away by itself but she says they told her that she needs the second scan in case there is a heartbeat. Why would they say that? Surely, after one private scan and one NHS scan it's a given that there will be no heartbeat? She's been given some hope now and I suspect it's false. I don't understand.

Oh, dear. That sounds quite horrible.

I have had 3 miscarriages and the chances of them suddenly discovering that everything is actually ok, when they have said that the baby died 5 - 6 weeks ago - I cannot see that being at all possible. (Not a doc but from my own experience).

In Germany and Switzerland where I had my m/cs, they take you in the next day at the latest to do a erpc. A natural miscarriage is very very very much advised against. Reason given is that there may not be a complete miscarriage and the tissues could get infected. In fact, this is a risk even with the tablet as far as I know.

If I were her, I would be going to a different doc to get a second opinion.

I feel really sorry for her.

Does she have details of the size of the foetus/sac and the exact dates. Surely they can go by that?

Hi MmeLindt
The private place said it was 4mm which works out to be 7 weeks but she is nearly 12 weeks gone. The NHS hospital said it's impossible to tell when the foetus died, which again doesn't ring true. Thanks

That sounds strange - they can tell by the size of the foetus what age it is and if that does not correspond to the dates - and your sister is absolutely certain she has her dates right - I don't see the point in making her wait.

Has she had her hormone levels checked? They should be able to tell by the hormone levels in the blood whether it is a viable pregnancy - if the hormone levels are not rising as they should then there is no way there is going to be a happy outcome.

This all sounds very strange to me - particularly after TWO scans. I had a MMC last year and my embryo was 5mm, apparently, and so they said it died at ~8 weeks. If she's now 12 weeks then if all was well there would be a little baby in there FFS! I'd be demanding an ERPC immediately. I had a scan on the Friday to confirm the MMC and I was in hospital on Saturday having my ERPC, so I really don't know why your sister is being made to wait and suffer unnecessarily unless there is uncertainty about her dates. But even so, if the embryo is 7 weeks in size then they should be able to detect a heartbeat if one is there.

I agree with everyone else.

There is such a discrepancy between the dates that a second scan shouldn't be necessary, and if I were your sister then I would be pushing for an erpc.

I had an mmc in January. I should have been 10+1 weeks but baby was measuring 7 weeks with no hb. That was a Friday and I had erpc on the following Tuesday.

As Gwendoline said, you can try again immediately, but best to wait for first af for dating purposes.

It might worth checking the travel insurance incase there's some clause for recent surgery/general anaesthetics. Physically she should be fine though, I recovered really quickly physically after my erpc although was unlucky and got an infection. Maybe they could prescribe her some ab's just in case.

So very sorry for her loss, she's going to need your support x

This website here states at 8 weeks fetal length should be 1.6cm - at 12 weeks 5.4cm.

There is little room for ambiguity.

A foetus of 4mm at 12 weeks - I cannot understand why they would wait to see a heartbeat that is obviously never going to be there.

How horrible to give your sister false hope.

Can she call the doc who did the private scan and ask for his advice?

Thanks everyone

Hi cazty, I had a similar experience I went for a scan at 12.5 weeks but the scan showed a fetus of about 5-6 weeks (3mm). I was sent away for 10 days to see if there was any change as they said they have strict guidlines they have to stick to and as you wouldn't necessarily see a heatbeat at that point they have to do a 2nd scan to make sure. I was adamant about my dates though as by the dates they gave me it meant when I did a positive pg test I wasn't even pregnant!!

There was no way I could wait that long (as when I actually got my re-scan date through it was 17 days away!!!) - so I went to the doctor and got referred to the EPAU. Within that week they confirmed a MMC, then less than a week later I had an ERPC. It's now 2 weeks since my ERPC - and I could have easily gone on holiday a week ago (a week after the ERPC) - they just recommend you rest and don't drive for 24 hours after - it was more the emotional side of things for me. I was sent away with antibiotics to avoid any infection. I was told I could start trying again straight away (once bleeding had stopped) - so no idea what the 4 months is about! As with any surgery there are small risks - but they explain all of these and the risks are very small.

I would suggest she goes to her doctor and make the doctor contact the EPAU whilst she's there - mine got on the phone straight away. Is she bleeding - as they get you in quicker if that's the case (pains and bleeding even quicker).

I'm sorry your sister is going through this - the system doesn't make it any easier for us either!

Thankis Cream and take care

A friend of mine was made to wait nearly two weeks for a ERPC for similar reasons - absolutely ludicrous and made things so much harder for her, being forced to go about her business with that hanging over her. For obvious reasons she couldn't face normal life until the operation was done so she ended up signed off work and suffering at home for two weeks. It borders on inhumane.

I had the same situation to your sister last month. Began to bleed and had a scan 10 days before my holiday. Baby was measuring 6 wks with no heartbeat although I knew from dates it should have been 12 weeks.

Dr doing the scan said that because there is always a chance that people get their dates wrong, hospital procedure is that they have to wait 7 days and do another scan. Only when they see that baby has not grown in 7 days(or natural m/c has taken place during this week) will they offer either an ERPC or medical management (pill). The other option is to wait to m/c naturally.

My (NHS) Dr told me that even though my 2nd scan to confirm the m/c would be only 3 days before my holiday she could arrange for the ERPC to be done that same day and that I would be OK to fly 3 days later. She also said if I had the pill that day it is likely that the m/c would usually take place around 48 hours after. My other option was to m/c naturally which I did not want as I did not want to risk m/c on holiday.

So conflicting advice to your SIL's Dr there- only a 7 day wait for a 2nd scan and able to fly 3 days after the ERPC. I would go back and ask for a 2nd oppinion. Have to say though my Dr was AMAZING and said I needed my holiday after such bad news!

Re the risks of surgery, my Dr said there is a very very small risk of a problem and in her 25 years she had only known of 1 case where there had been a real problem. She also advised on waiting till you've had 1 period after ERPC before TTC again, not 4 months.

So sorry for your SIL, it sucks.

Thanks Georgie and Mr Claypole xxx

Hi there. I had a erpc at the end of November and I actually travelled overseas 4 days later (from South Africa to Europe). After that i spent 20 days in a cruise, crazy, i know, but everything had been booked 6 months earlier and i thought that t would be better than spending Xmas at home and without family (apart from hubby and my twins, everyone else is in Brazil). I didn't regret it, I had a great physical recovery, but emotionally it's a little bit more difficult so it takes more time....so sorry for her, it's really horrible and you never think it's going to happen with you until it does...