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Miscarriage/pregnancy loss

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Misoprostol medical management - my experience

4 replies

Wantohope · 17/09/2013 14:25

I am writing this hoping that it will help provide some information for anyone else who has decided to go down the medical management route.
I am sorry if it is too long and maybe some TMI at times, but I am doing this hoping that it will help reassure someone else in their moment of need.

I was prescribed Misoprostol/Cytotec 7 pills, 200 mg each by a private ob-gyn after the u/s showed a missed miscarriage.
I was told to take 4 vaginally (insert them as deep as you can) and then (if the bleeding doesn't start within 4 hours) take the other three orally, one every 4 hours. The ob gyn said I should start the treatment in the morning so I can some sleep during the night but I chose to take them in the afternoon, because that's when my husband could be at home with me.
I inserted the first 4 pills at around 4.30PM and by 6.30 I started to get some light cramping. It didn't bother me in the slightest, it felt as if my af was about to come on (at this point I took some nurofen express, preventively) .
After another 30 min I felt a very sharp pain traveling from the front of my pelvic region to my rectum, followed by an urge to have a bowel movement. I ran quickly to the toilet and the movement was quite painful, my rectum really hurt for a few seconds and it got me scared.

Then I started having serious cramping so ran a hot bath and completely forgot about the pain mentioned above. I just sat there and within the next 20-30 minutes the cramping got gradually worse to the point it became unbearable.
I do not want to worry anyone but I have to be honest, the pain was so bad I thought I will pass out. I had no idea my body could take so much pain. I think these were contractions (never been pregnant before so I might be wrong) and they came in waves, every few seconds. At some point they lasted like a whole 10 minutes with no respite. I felt like I wanted to pull my hair and my eyes out, I was trying to breath and calm myself but God...it was extremely painful.
I have always suffered with painful periods (until the beginning of this year when they got much better) and I can take pain, but this was something else.
My vision got a bit blurry and I started to feel very shakey so I asked for something sweet. My husband bought me 2 boxes of chocolate the night before and brought them into the bathroom. I had a few pieces and started to feel calmer, the contractions stopped (this was just a coincidence, I am sure, but I went on and finished the chocolate within the next couple of hours anyway).

This very painful episode lasted about 1.5 hrs and then the bleeding started.
A few drops in the beginning followed by very small clots.
By now I have emptied the tub and run a hot shower over me. I think the bath was a brilliant idea at the time and really helped with the pain, but I've read that you risk infection because the cervix opens and got worried about it so I decided to go for the shower once the pain got more bearable. As soon as I felt another contraction I would turn the shower very hot and run it over my tummy. I don't know how much I bled, maybe like a very heavy period.
All this time I had horrible hunger pains and got out of the shower to have dinner.

I then returned to the shower and stayed there until 5.30 in the morning when the pain was more like a period and I moved to the sofa.
I have slept from maybe around 6 AM to 8 AM and then another 2 hours.

I have changed 3 or 4 very thick pads but the bleeding has not been worrying at all. It is not a lot on the pad but there is some serious bleeding every time I go for a wee. Some black clots coming out, a few pieces of something that looks like chicken liver, but these are very small, peanut sized or slightly bigger and haven't passed anything larger than that.
I have only slept 4 hours in the last 30 hours, I don't feel sleepy at all, however I feel weak every time I need to get up and go to the bathroom.

I feel hungry all the time and my tummy is very bloated. The pain is very manageable and I took my last nurofen around 6 o'clock this morning, nothing ever since.

Now, I am worried that I am not eliminating everything? Is it normal to have only small clots? I have read that normally women pass things the size of their palms and these are grey, not red?!
I continued to take the rest of the pills orally even though the bleeding had started after taking the first dose because I thought it will help completely remove everything.
Is this normal?

OP posts:
Bakingtins · 17/09/2013 16:31

Hi want I think you are quite right, you have been very brave. I've had 4 miscarriages and only once been aware of the sac ( at between 8-10 weeks) other times it's just been clots. It depends whether it is passed intact or broken down and how big it was in the first place. You ought to have a follow up scan to check your uterus is clear and no material is retained, or at the least be told to take a pregnancy test in a week or so and be followed up if it is still positive.
Hope the worst is now over for you. Let your husband take care of you and take your time, you need to recover physically (and emotionally though that takes longer)

jnl0612 · 17/09/2013 21:38

I had a mmc at 16 weeks I took them to dilate my cervix before my erpc (I've had 2 previous sections) it was the most hideous 2 hours ever. Contractions coming every 2 minutes, blood actually pumping out of me ( sorry tmi) your very brave to do this yourself. Hmm

Wantohope · 18/09/2013 13:12

Bakingtins Oh my God, I had no idea you had 4, I am so so sorry:(( Yes, I am booked for a follow up u/s at the EPAU. I was hoping that I will eliminate everything and won't need a D&C after all I've been through. Otherwise this whole exercise would have been pointless, I really wanted to avoid surgery. Fingers crossed it will be ok.
I know nothing about sizes, etc; I have been told it stopped developing just before 6 weeks, should there have been bigger clots coming out?

jnl I thought that if you choose surgery you are spared the pain of contractions, but it seems that with ERPC you get both. That really is horrifying.

Thanks
OP posts:
jnl0612 · 18/09/2013 14:47

I had both because usually at 16 weeks you pass it naturally but because I've had 2 sections and never had a natural birth they didn't want to risk rupture. Wasn't nice tho

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