Missed miscarriage - could they be wrong?

[KingOfLizards]

Hello. This is my first pregnancy. At my 12 week scan last week the sonographer told me that the embryo had no heartbeat and measured only 8 weeks 4 days, and that I would miscarry. I chose expectant management, but a lot of reading over the weekend convinced me that the chances of the miscarriage starting spontaneously any time soon are very low (I've had no signs of miscarriage, no cramps or bleeding at all). So I asked for surgical management instead, and the hospital have offered me a slot tomorrow.

I'm now (irrationally, I know) terrified that the sonographer made a mistake, that maybe my dates were wrong, and that the consultant is going to terminate a healthy foetus. I've asked for a reassurance scan beforehand, and the nurses were sympathetic to my request, but I don't think that they will be able to fit me in.

The NICE clinical guidelines (www.nice.org.uk/nicemedia/live/14000/61854/61854.pdf) seem to suggest that the proper procedure for diagnosis of a miscarriage should include more than just one scan, or at least more than one opinion. This is from the guidelines:

"1.4.4 Inform women that the diagnosis of miscarriage using 1 ultrasound scan cannot be guaranteed to be 100% accurate and there is a small chance that the diagnosis may be incorrect, particularly at very early gestational ages."

I know I'm clutching at straws, and I'm sure the sonographer knows what she's doing, but I just wish I could have some reassurance. If you have gone through this, were you offered a second scan, or some other confirmation?

Thank you.

I'm so sorry you are having to go through this and I can completely understand your worries.

My situation was different but some aspects of it may help you.

I had a mc at 10 weeks and had a scan that showed a complete spontaneous miscarriage. They then took blood samples to check htc levels and again a week later to ensure the levels were dropping. This extra check was to back up the scan results.

Are you having your levels checked? You should absolutely have every reassurance that nothing has been missed.

• hcg levels.

Thanks for your reply, MrsHowardRoark. I've not had any blood taken at all.

When the surgery was first discussed I was told I would have to come in the day before for blood tests (although I'm not sure what those were for). But now I've been found a slot for tomorrow (they called htis morning), and they said I needn't bother. So I feel like I'm going into it with no reassurance, and just the one sonographer's opinion.

My experiences of those awful scans is they call someone in for a second opinion at the time. I've not had ERPC, but can see you need to be sure in your own mind before allowing them to go ahead. I'd ask again tomorrow. Hope it goes as well as possible for you.

My experience was they took 2 scans a few days apart, even though we all KNEW there was no hope... because the consultant wanted to be 100% sure there wasn't an earlier pg or whatever. I also had bloods 48hr apart.

Having said that, once they know, it is mainly psychological comfort the 2nd scan. You will have an opportunity to talk to the surgeon so use it to discuss this and get reassurance.

Thanks Bakingtins. No-one was called in for a second opinion, but thinking about it, the sonographer left us alone for a while after she told us - maybe she was discussing it with a colleague?

Hi Squizita. I definitely don't feel hopeful, but there is just this tiny little nagging bit of hope that won't go away. I'm sure talking to the surgeon will be really helpful - thank you for that information (the hospital didn't tell me I'd have that opportunity).

I have had 2 mmc on both occasions I had to wait a week & be rescanned but in both incidents this was a formality as there was no hope. I think they scan in theatre before the erpc even if you aren't aware of it
Sorry it happened its properly rubbish x

Ask for another scan when you go in.

I wish we had done the same as its something that has always bothered me. We didnt get a second scan, another Dr popped her head around the door, looked at the screen and said sorry. I think that was our second opinion. I trundled off to another room to take the first tablet an hour later. It was all so fast i didnt have time to think

If you have a nagging doubt already then it will not fade after the ERPC.

Hey, I don't usually post but I felt I had to reply to you. You have to postpone op until you have had a second opinion either another scan or by bloods 48 hours apart, if you get the op, your niggling doubt won't go away afterwards and the thought will torture you. My story is I went for a scan and was told sac wasn't formed properly ( I don't know what they meant by that) and there was no heart beat. They wanted to do the op to empty the womb, but I got so upset I ran out the hospital, I was the same as you and thought there may have been a mistake, I didn't want to believe it. My son is now coming up for 8. I know it's highly unlikely they have got it wrong for you but for your own sanity you have to get it confirmed xx

Thank you all for the help and information. I'm sorry so many have had to go through this.

If I know that they do do a scan in the theatre as part of the procedure that will be enough reassurance for me, so I will definitely ask.

If they don't then I'm not sure I should go through with it without confirmation.

I'll find out tomorrow I guess. I think I need to stop obsessing for now! Thanks again.

namechangedjustforthis, your experience sounds extraordinary! How many weeks was your scan?

In my case, I don't really expect that a mistake has been made. I just feel like I haven't had enough confirmation.

I'm sorry you're going through this

I had MMC diagnosed at my 12 week scan. I didn't believe it at first, thought there was a mistake etc. I think this is a completely normal reaction. The more I thought about it though, there was no possibility that I was so far out on my dates - I'd had a positive pregnancy test at just under 4 weeks, baby was measuring 8, and by my dates should have been nearly 13 weeks at that stage, so it wasn't possible for me to only be 8 weeks along. I asked the sonographer and she said I could be rebooked for a scan a week later to see if any growth/change but she was 100% certain that I'd miscarried. I had ERPC 2 days later, I couldn't keep it dragging on and just wanted it over so I could try to move on.

6 weeks later and I'm glad I had the ERPC done ASAP, it has been incredibly emotionally draining and I would have felt even worse if it had taken longer than necessary.

I'm so sorry. :( I had a MC at 12 weeks, although did start bleeding. Once at hospital I had an internal and the doctor told me my cervix was closed so it could be a threatened miscarriage. At scan, an hour later, the sonographer confirmed miscarriage and because it had already started she was unable to tell me when the foetus had died (unclear) and there was no heartbeat. I booked in for an ERPC the following day and requested a scan beforehand, mainly to see if I had passed enough of the tissue not to have the procedure (was flying the following day). They allowed the scan but it had to be in the EPU. Would this be an option? I understand your needing a second opinion - it is unlikely they have got it wrong at this stage sadly, but I don't think they can deny you the option of a second scan, just to confirm things. If your first scan was through the main ultrasound department, see if you can get a midwife to refer you to EPU in the morning, for a second scan before you go through with the procedure. Again, so sorry you're going through this.

Sorry you are going through this KingofLizards, it is very hard.

With the embryo measuring 8weeks4days, if your dates were wrong, there should be a heartbeat. So it does look very much like it is a missed miscarriage.

Having said that, you really should only go for the surgery if you are 100% convinced it is right for you. Mistakes can be made and you have to know in your heart that it is right. Please insist on another scan before the surgery tomorrow, if they cannot do this for you, you can request a postponement of the surgery and get bloods done or scan in a few days. Putting the surgery off for a few days is ok if you want to do it. The only possible thing that could happen is that you might go into a natural miscarriage before they get to surgery.

For my miscarriages I have experienced each of surgery, spontaneous and medical miscarriage, and I have to say that each has its pro's and con's and it is down to personal comfort as to which is right for each woman. But don't do anything until you are certain it is right for you, going for surgery with doubts will not help your recovery.

I hope they are able to reassure you before tomorrow.

Thinking of you today.

Thank you all for your kind words and helpful advice. I was able to get another scan at the hospital yesterday morning. The sonographer confirmed the earlier finding and talked me through how the diagnosis was made. When I had all the information, I was much more comfortable with the decision, and I had the ERPC yesterday evening.

The hospital staff were all wonderful; I couldn't be more impressed with their warmth and professionalism. Doctors, nurses, anasthetists - even the orderlies who wheeled me down to the theatre - everyone who was involved was so caring, courteous and helpful that I felt informed and involved every step of the way. The NHS is a precious thing, and I'm truly grateful.

I'm now back at home, being waited on hand and foot by my infinitely kind partner, so although this has been a difficult time, it's nowhere near as bad as it might have been.

Oh I'm glad you got the second scan and felt reassured (well, as reassured as you can feel in a situation like this :()

I felt the same about the care I had whilst in for my ERPC. Feeling cared for and informed makes all the difference, I think.

Hope you manage to get some rest. Your partner sounds lovely and it sounds as though you both have a really healthy outlook on things which is great.

kingoflizards - I am relieved to hear that you had the reassurance that you needed and felt comfortable with your decision, and really good to hear that your partner is being so good to you. I hope you are able to take it easy over the next few days, and have the time to heal physically and to take time to grieve for your little one. So sorry for your loss.

Hey all. So I finally miscarried this week. Thought I'd share my experience as it's good to reflect but also found reading all these personal stories so reassuring. Hopefully this will give other people some guidance on what they might expect etc.

So private scan on 29/4 should have been 10w6d. Scan measure 6w6d. Knew dates couldn't be wrong as had positive test on 10/3. I was devestated. Had all the pregnancy symptoms. I got referred to early pregnancy unit for a scan but they made me wait 9 days to the following Monday 8/5 as they wanted to compare growth in case dates were wrong.

It was the longest week of my life. Real emotional ups and downs. I decided not to go to work tues-fri, as a PE teacher didn't want to get caught in a lesson on a field with no toilet facilities nearby. It filled me with dread. There was also an element of shame as a handful of people new and I wasn't ready to tell anyone the sad news. The whole time I was at home I was obsessing over what an MMC was, what will happen in an MC, whether my dates could be wrong, what my options were. I have to say the waiting around was worse than the actual MC for me. I wanted to have the d&c as quickly as possible as I was petrified of miscarrying naturally at home.

I had cramps off and on the week building up and all my pregnancy symptoms disappeared four days after the first scan and the sad news. Interesting how body catches up once brain knows. The next bit has a bit more of the gorey details (I found this helpful to read) but if you are squirmish, skip it!!!

My first MC symptoms started a day before the scan when I was exactly 12weeks. Started with brown discharge and more griping cramps. Couple of hours later proper red scarlet blood when I wiped. I never really got a heavy flow like others described. Not sure if this is because the baby had died 5/6 weeks earlier so had broken down or whatever? Who knows. Lots came out when i sat in the toilet but not much actually into the sanitary towel.

The next morning I rang the EPU as I was unsure whether they'd still want to scan because of bleeding. They were lovely and said they still did and wanted to know I was ok etc. The Dr and Nurses were so nice. She confirmed it was an Mmc, that the sack and fetal pole we had seen in scan (I took a copy with me) were just big dark blobs now because they had begun to break down etc. She showed me my uterus and where the pregnancy tissue was and also checked my ovaries etc and said everything looks healthy and normal. She told me to do expectant management as it was very low down and said it should all come out within a couple of days or so. She signed me off work for another 5 days and told me not to rush back and to take this time to get body and mind back. She said that when the sac/embryo comes out that I will get sharp pains and likely to feel a 'gushing' sensation. She also said that we could try again as soon as I wanted which was nice to know as so many people say you should wait a while. Good to know that medically there is no reason to wait if you don't want to.

Anyway, went home prepared for the worst. The whole thing lasted only 4 days. Sunday- Tuesday I had average bleeding but really bad low ab pains, some just like crappy period pain then other times waves of contractions that took my breath away. All I could do was take paracetamol, have a hot water bottle constantly, breath deeply, curl up and watch tv, eat chocolate and even some wine when I was up to it. On the Tuesday night the cramps changed. It was more like what I can only describe as 'pressure' deep in my uterus really low down. Constant - like super long contractions that lasted several minutes would ease off and then be back moments later. Almost like having a toddler sitting on your lap when you have period pain and a full bladder. Felt like it was going to pop! Or like waistband was cutting into my bladder. It felt hard and bloated. But I had no bleeding at this point so didn't know whether this was the big build up or just my uterus being angry! I went to bed dosed up on meds and my water bottle and hoped for the best. I woke up at 5am, sensing I'd started bleeding again. Went to the loo and suddenly without any pain, something definitely fell/gushed out. I chose not to look, but I knew it was the 'big' but I'd been waiting for. About 50p size. And instantly I felt a real sense of relief once it had happened. I got cramps and some bleeding for about 3 hours after. This was this morning and I have just experience my first afternoon of no bleeding or cramps (at all!!!) and enjoyed an evening out with the Hubbie. I feel sooo much better, as light as a feather, that this nightmare has finallly come to an end. I've had no bleeding and just occasional twinges in uterus. But taken no pain relief since 6am this morning.

I know everyone is different. From my experience of reading these experiences from people, no two stories are the same. But reach out to people. You are not alone. People don't talk about miscarriage enough. I had no idea that you could MMC. We (women) have to put our minds and bodies through the most stressful experience of making and growing a baby. It's not as straight forward for everyone. Friends and family who haven't been through this will try and say the right thing. But they will never know how you are feeling. We can only learn by others. To anyone who's just found out they have MMC my heart goes out to you. All I can say is every day that passes will get that slightly bit easier. If anyone every wants to chat feel free to message me xxxx all the best for your baby making futures xxx

Bdunta123, how are you feeling now?

Last Thursday I went to my 12 week scan and was told my baby had no heartbeat. I was measuring at 8 weeks and 4 days.

I had an ERPC yesterday and now recovering at home. I am finding it hard - emotions are all over the place and I feel lonely at times. My husband is being very supportive but I can't help feeling like I've failed. I'm hoping time is a healer.

I experienced this today. Just finish telling half of the family and announced my pregnancy to my work collegues. Went to my scan with partner and mother in law, and there was no heartbeat with gestational sac measuring at 9 weeks. My bladder wasn't as full as I thought so was hard for sonographer to find in the first place. Still getting positive tests and it would be 3-4 weeks after the missed miscarriage. So after my initial shock I tried reasoning that she just couldn't see/hear due to my bladder not being full. But after reading through multiple forums online it's pretty clear now that the scan wasn't wrong. I go tomorrow to arrange the next step, and I guess will be letting everyone know after the weekend is over. Thing is I stopped feeling pregnant(mentally) a few weeks ago and I thought it was just because all the symptoms were easing off as the pregnancy was settling in. I feel for everyone on this thread, it has been a horrible day. Went in excited and left crushed.

Totally feel for you ladies. This happened to me too though not at 12wk scan - I had an early scan and knew I was 7+3 or 7 at the very very least as had been using digital OPK's and tracking sex. Baby was measuring only 6 weeks and I was fobbed off with "you must've got your dates wrong"

Skip forward to when I should've been almost 10 weeks and I had a small amount of bleeding. A&E referred me to the pregnancy assessment unit and they did a scan. It appeared to have stopped developing around 6 weeks even though we had seen a heartbeat on the early scan.

Had the tablets just under 2 weeks ago and now on the slow road to recovery. It totally sucks. There really is nothing anyone can say. Just hugs. xxx