What happens at/after scan at EPU once they confirm MC?

[AWomanCalledHorse]

^^ What the title says really [hsmile] I've googled & searched here like mad but can't seem to find anything that answers my specific questions.

I'm going to the EPU tomorrow or Wednesday to have a scan (between 6-7 weeks pg, does that mean a 'dildo cam'?) to check on what's left behind.

I know I've had a mc, as I've been bleeding clots & bits for the last 5 days & have had 0 symptoms of pg since it started.

Will they let me know there & then if I need a erpc?

Am I likely to have the erpc on the same day or will it be scheduled?

Is bringing DH to the EPU a no-no?

I'm going to Queen Elizabeth's in Woolwich if anyone has experience of what to expect there?

If anyone reads/responds I am very grateful in advance

So sorry you are going through this.

I'd have thought that if you have been bleeding then they won't need to do an ERPC? At the scan they'll be able to see how much is left and whether you need it, I assume.

If you do need one they won't do it there and then. It is under GA so you need to be nil by mouth for 6 hours beforehand. I know that my local nhs hospital only does them on one day of the week.

Hope someone with more experience can come along soon and help. I have just had an ERPC but had it done privately, so I don't think my experience was typical. I had the scan showing the MMC one evening and the ERPC the next evening. I wasn't bleeding, and apparently showed no signs of bleeding anytime soon (12 weeks).

Hope you get some answers soon. The not knowing what to expect is horrible.

I'm so sorry

I had 2 m/c and was scanned internally with both of them after I had miscarried. I had miscarried completely so didn't need an erpc, but they told me that at the scan. DH came with me to all the visits to EPAU and was a great support.

Hope you're OK.

Thank you both for taking the time to respond.

MrsJohn, the erpc info you've given is very helpful (it's more so we know what to expect, so DH can arrange time off with work).

MissBeehiving, (ooh it feels all formal with you 2 both having titles!) thanks for sharing your experience.

I'm hoping they can say to me 'ooh you were only 4 weeks along' as the idea of being far enough along for there to be a detectable heartbeat makes it feel worse, if you know what I mean?

I'm sorry you've both got the knowledge to reply x :(

So sorry you're going through this Horse
I've had three miscarriages this year.
The first in March was at 10-11wks. I started spotting and was booked for a scan at the EPU 5 days later, the night before I was going in I had progressed to very heavy bleeding with clots but when I was scanned(transabdominal) was told baby was gone but there were still "products of conception" remaining. I was given the option of being booked for medical management, coming in for an ERPC the following day or waiting to see if I would progress naturally. I had bloods taken for HCG levels. We decided to wait and I went on to pass the placenta etc over the next three days. I was slightly unprepared for how painful it was and how bulky the material passed was(not like a heavy period as I was told!) but it was bearable. I had blood repeated the next week and a further scan the week later. At this scan(transvaginal) I was told the miscarriage was still incomplete so I had to have more bloods and a further scan 2 weeks later so the whole process was very long.
I conceived after my next AF but miscarried at 6 weeks, this time by the time I was scanned at the EPU a week after bleeding had started the miscarriage was complete and blood HCG had dropped quickly so I didn't need any intervention.
We didn't wait to ttc and conceived when I ovulated 14 days later!
Unfortunately despite two early scans showing a good heartbeat and normal growth we found out at a 10 week scan that heart had stopped at 8w6d. I once more was given the option of ERPC the next day or waiting to see if I would miscarry naturally. I decided to wait as I have other dc who didn't know I was pregnant again and I really didn't want a hospital stay unless necessary. I was booked for a rescan 2 weeks later and started to miscarry the night before, on the scan pregnancy was still there but because I was bleeding so much I was told it was likely to pass naturally,and though I was once more given the option of ERPC if I wanted, I went on to do this in the next 48hrs .
I had been booked for bloods /rescan the next week, was told it was still still incomplete and had a further scan 2 weeks later,once more quite a lengthy process.
So I think miscarriages vary, even for the same person and it depends on your individual circumstances,your preferences and your EPU how it will be handled.
My DH was there (and a great support) for initial appointments but I didn't keep bringing him back as I had so many appointments and by now am on first name basis with most of the EPU staff anyway!They were lovely.

x

I'm so sorry you're going through this. I have my fingers crossed for the best for you (I bled with clots at around six weeks and she's six now) but you know your body best.

It's my local hospital (well, until Thursday, but it has been for the last 8 years!) and I've had two first trimester losses and I bleed a lot too in pregnancy so I'm quite familiar with the EPU there.

First off, they're very nice.. well, the nurse practitioners are anyway. The sonographers are a mixed bunch, same as anywhere really. Some are lovely, others are more clinical and emotionless which is sometimes what you want, sometimes not. The sonographer will NOT diagnose anything. Usually what happens is they call in a doctor, and it's then you know it's bad news. Some sonographers don't let you see the screen until they've determined what is what either, or even not at all if it's not good although I think they probably would if you asked.

Sometimes they don't call the doctor in but they don't tell you what they've seen, and you have to wait to be seen shortly afterwards by the nurse practitioner. You have a fair idea what the news will be by the position of the box of tissues on her desk.. near "your" chair or neatly back with her pens and stuff (this part always brought a bit of dark humour for me during a miserable time!) Although by that point if the sonographer hasn't shown you anything you'd probably be fairly sure anyway.

It'll be dildo cam at some point, yep.

It's totally fine to bring your DH - they are very welcoming.

You can ask them for a free scan photo if you want to as well.. unlike the later on scans, they don't charge for these, but they don't offer them either unless you ask. Some will, some won't, and of course there a) may not be anything to see and b) you may not want one either.

Get there as early as possible, maybe even 15-30 minutes before they officially open, so you're near the top of the queue. If you arrive when they officially open you'll find you're about sixth or something and could be there for hours.

You won't get an appointment for an ERPC same day. If they deem one necessary, at the earliest they will book you in the next day so long as they have availability but they generally have I think.

I hope you get some surprisingly happy news tomorrow, but if not, I hope they treat you okay and you get a nice sonographer! The trust may be bankrupt but it's business as usual up there.

Hi Horse. I'd def take your DH, emotional support is invaluable. It is likely to meam dildo cam, I'm afraid, but it's not that bad. I second the suggestion to get there EARLY because they tend to operate on a first come first served basis and because bleeding in early pregnancy is so common there will be a lot of worried people there and sitting with them for a few hours is not fun. It may not be bad news for you - I've had heavy bleeding in all my pregnancies - 2 bouncing boys and 2 miscarriages later I am a frequent flyer at EPU ...
If you are bleeding already you may not even be offered an ERPC. If there are retained products then normally they'll take a wait and see approach and rescan you in a few days, or offer you medical management (inserting pessaries to make the womb contract). If they do schedule an ERPC it's not likely to be immediate anyway. If you are sent home make sure you have been given a clear idea of what is normal and when to contact them for advice, and that you have a 24 hours contact number for them (usually the gynae ward when the EPU is closed). My first MC was a very frightening experience and I did end up in hospital as an emergency and they were all "why didn't you call us?" "because you sent me away to MC on my own with zero information or support and I had no idea what was normal!" I hope that doesn't freak you out, I just want to encourage you to ask lots of questions about whatever course of action is recommended. Another reason to have your DH along.
I really hope it is better news than you are expecting. We are here for you either way, and on the TTC again thread whenever you are ready.

IrishMammy, I'm sorry for all your losses. I hope next year is kinder to you.
Thank you for sharing.

Murder, thank you for the local knowledge, I'll aim to get there for 8-ish as they said anytime from 0830 onwards. Hope your move goes well!
Sorry for your losses.

messtins, sorry for both of your losses, but esp the first one, that sounds like a horrible experience!

I, in a twisted odd way, would rather they confirm it's over than have a surprise for me as it means; I know my own body (this hasn't felt 'right' since BFP) & I get to start over again, I've already cried & come to terms with this loss so finding out it's not a loss will probably knock me for six (hope I've not offended anyone).

A final question, if I'm lucky enough to get pregnant again...will I be offered NHS early scans because of this?

Thank you all again for replying, it's been very helpful. x

Hi Horse so sorry you are going through this :(

I had a MMC in Jan this year. Went for 12 week scan and baby had died at 8 weeks, luckily for me I had had a 6 week scan so I had measurement to go by, otherwise they would have let me go another couple of weeks, incase my dates were wrong.
I went back in the next day to see consultant who offered, surgical or natural option. So I took ERPC as didn't want to hang around, knowing I had a dead baby in me was horrendous. I was then booked in for the next day.

Please take DH with you, you will need support, it is not a no no to take him along.

If you need any further advise regarding ERPC please let us know.

With regard to future pregnancies, I think it depends on your GP. Mine is fab and always books me in for one. I had an ectopic 4 years ago, luckily my GP referred me foe a scan at 8 weeks and it was discovered early. Next pregnancy he referred me for scan straight away that I knew I was pregnant (8 weeks as it was straight after tube removal) and then this third time I had one at 6 weeks, which showed all in the right place, but sadly died 2 weeks later.

thinking of you today :(

Yes, I felt relief when they finally diagnosed miscarriage with my second loss - I knew it wasn't going to work out and just wanted to start over with one that did. I'd already done a lot of grieving and shouting at the universe which meant I could focus on the practical parts like ERPC without the emotional aspects quite so much. It's not wrong to feel that way although they probably wondered why I seemed quite together for the surgery.

As has been mentioned it will depend on your GP if you get early scans as I don't think the EPU has a lot of say in it unfortunately.

Good luck tomorrow!

I was told by EPU if I get pregnant again to just lie and say I had pain or bleeding so GP would refer me as that's the only criteria for getting an early scan (may be different in your area though). They recognise the need for reassurance but you have to be prepared to lie to get it....

Sorry for your loss OP. lots of good advice up thread, just one correction, in my case I had very heavy bleeding and huge clots (the size of my hand). Then it stopped and all seemed fine. But a further scan did show retained things including the sac. I did have the erpc and for me it was the best option. All over and pain free within the day with no over night stay. It's not a risk free procedure, but what is?

Sorry you're going through this horse

I imagine tomorrow you will have an internal scan and also have a blood test. I had a miscarriage in May at around 8 weeks and although, like you, I knew before I went in it was all likely to be over I had to go in four times I think over two weeks for scans and blood tests before they would confirm it in case my dates were wrong. Unfortunately they don't necessarily say immediately that it's likely to be a mc (during my 1st scan (external) I was even told 'there's a heart beat it's probably ok' before she then decided she was mistaken and there was no heartbeat when she did the internal one )

I felt exactly the same way about wanting to hear the bad news rather than being told things were ok so I think that's quite normal. With out wanting to be depressing about things, make sure you give yourself time to get over things emotionally, I never realised that an early mc would still be upsetting several months later and probably still have a bit of a cry every week about what happened (especially as the due date approaches and I'm not pregnant again yet)

Good luck tomorrow

Yeah, I have to say I had to fight hard to get my ERPC second time round at the EPU. They like to scan two weeks apart (sometimes a week) before they will declare it a loss. Unfortunately for me, with the first scan, when I was supposed to be 8 weeks by ovulation (I was charting including temperature taking, so very accurate) they saw a very slow heartbeat and the baby measuring 6 weeks. They assured me this was "fine" and the pregnancy was viable even though it would have meant me getting a positive test a week before I'd even conceived, AND they'd scanned me at 5w3d and seen a pregnancy measuring 4w3d. So even by their standards I'd already lost a week somewhere but they were conveniently not including that scan for reasons I could not fathom. I knew I would miscarry naturally within the week and I was terrified of that, especially if it happened at work, so I went private and got it all sorted.

That's my only criticism of that EPU - I know they have their procedures but they didn't seem prepared to listen to me and my evidence, and they refused to do an ERPC when a heartbeat was present unless I went down the whole abortion route.

It is quite possible that you may encounter similar in terms of them requiring you to wait weeks and not believing your dates, I really hope not. They really are otherwise lovely.

How did it go today?