missed / silent miscarriage. 2nd miscarriage in 5 months : (

[funkymonk]

I was diagnosed with a missed miscarriage on tuesday at what shoud have been 8+1. The week before we had seen a lovely heartbeat during a viability scan. How devastating.

This is my second miscarriage. The other being in July this year.

Yesterday I opted for medical managment and was given some pessaries at the hospital. A few hours later I developed cramps and passed quite a few clots and grainy type stuff. Overnight it stopped and today there has been a few drops of blood only. Was that it? Is it all over already or has the medical treatment failed? I thought I was meant to bleed for a couple of weeks?

I desperately do not want an ercp if this has failed, as on research up to 30% of women can develop Ashermans syndrome (scar tissue that can lead to infertility). I have no children and got my last bfp on cycle 12 of trying.

Does anybody else have experience of medically managed missed miscarriage?

Thank you.

funkymonk I'm so sorry you are going through this again. I've had medical management for an incomplete miscarriage (had bled but not passed sac) and had 2 doses of the pessaries 24 hrs apart, the second one worked. I would think at 8 wks gestation you would expect more than what you describe (mine have been between 8-10 weeks and have involved several hours of v heavy bleeding until I passed the sac, then about a week of bleeding like a period)
I would contact EPU again and ask to be rechecked.

Thank you baking for your reply. That's really helpful. I will contact them first thing.

Sorry for your losses.

Hi funky, so sorry to hear of your loss. I saw you on the antenatal thread. I had a natural miscarriage on Tues. It's so awful, and almost cruel that the day before we saw a heartbeat (although was only measuring at 6 weeks and should have been 8 so we knew something wasn't quite right).

I cannot imagine what it would be like to experience this again, my heart really does go out to you.

Take time to look after yourself, hope you have good support around you x

Thank you Morgan. So sorry for your loss also and ditto to look after yourself xx

Sorry for your loss funky my first miscarriage happened without any medical intervention at nine weeks and I bled on and off for three months, until one day this horrible piece of shrivelled tissue popped out in the bath. I think it was the placenta. With hindsight it wasn't normal to bleed for that long and I should have sought help. My point is that it didn't stop me from getting pregnant again. I had an ERPC with my second miscarriage (which was a mmc) as I didn't want to go through the pain and bleeding again. It was fine and again it didn't stop me from getting pregnant again.

I'm sorry this is happening to you. I mc'd at 8 weeks earlier this year (also a mmc, as the foetus had stopped developing a couple of weeks earlier). Every mc is different, but at 8 weeks I would have expected more to come out. Do you still have cramps? A clot could be blocking the cervix. It would be worth going back to hospital imo. I bled for about 2 weeks in total (natural mc).

I'm really sorry this has happened to you. I had medical management for my second miscarriage. I had some pain, some contractions for a while and then passed the pregnancy sac, and had some bleeding with a few smaller clots during the days that followed. While I was in the hospital quite a bit came out. However, once the main sac passed, the contractions stopped immediately and i just had a bit of dull achiness, a bit like period pain, for the next day or so. You should phone your EPU where you were treated for advice.

You will know if it is complete if you get a negative pregnancy test result in two weeks time. If not you will need to be rescanned at the hospital.
I don't know where you are getting the information about Ashermanns from but 30% seems a very high number. Ashermanns syndrome is rare and many women have surgical management of miscarriage each year. I had this procedure with my first miscarriage with no complications whatsoever, as have many women who have posted on here. If you have got your figures from Dr Google I would have a chat with your doctor about the risks if it turns out your miscarriage is incomplete. However, you do have the option to just wait it out naturally.

I'm so sorry, funkymonk. I miscarried this year in May and November, by 5th and 6th mcs altogether. During the 5th I had reasonably mild cramping and passed the baby (8-9 weeks), then an ERPC next day as I had been booked in and there was still too much intact. This time I bled quite heavily for nearly a week, then had tablets as things were still there, bled for a few days, gynae scanned and discharged me, it stopped for nearly a week then around a week ago now I had a few days of intermittent gushes. It has stopped completely now and I am crossing my fingers it will stay stopped. IOW, you may be through or you may start bleeding again and still be fine. Are you having your blood hCG monitored? That can give you an indication of whether everything is 'out'.

I am fortunate enough to also have two children, and I conceived dc2 4 months after having mcs 2 and 3 in consecutive cycles and an ERPC each time. I have had four altogether and haven't ever had issues - the risk of Asherman's is really quite variable and minimal with a skilled surgeon.

My varied and unfortunately extensive experience with all this has lef me to conclude that all three methods of dealing with mc - wait-and-see, medical and surgical - have their risks and their 'advantages' (ha) of different natures but that the overall level of risk or whatever is pretty much the same. Doesn't make it any nicer a choice, though.

(Waves to Baking - hope all is OK xxx)

Thanks everyone and sorry for all of your losses also.

I contacted my Epu and they said leave it until Monday incase the bleeding gets going again. They said as I bled initially they didn't want to give more now and risk haemorrhage. ?? The verbal infornation they have given me compared to their leaflets completely contradicts itself.

They haven't taken hcg blood levels at all. Should they of?

I read about ashermans syndrome in a few papers on PubMed. I guess it does depend on skill of surgeon which I would need to enquire on should it come to that.

Is it obvious when the gestational sac comes out? May I just think it is a large blood clot?

Reassuring to hear of success stories after more than 1 miscarriage.

Hope you are 'in the clear' now Picard.

funkymonk I'm so sorry for your losses.

I would expect some more bleeding tbh. I hope your body sorts itself out and you don't need any further intervention but I know lots of women who've had an erpc and not had any problems. Is the hospital planning to scan you to check all is ok?

I don't know if it helps but exactly 11 years ago I was miscarrying for the first time. I had a second mc 6 months later followed by 3 successful pregnancies in 3 years. I know when I was at the stage you are at I felt very scared about it all, just wanted to say hang on in there.

Be really kind to yourself.

You might not recognise the sac - I only have in one of four miscarriages and only because I was trying to catch everything for testing. Other times it went down the loo in amongst huge clots

Hi funky, mine was a natural mc but at 7+2 I had far more bleeding than you have described. Not sure if the medical management makes a difference to the amount of blood to expect though.

Thanks everyone for your advice and experiences.

Hi Funky, I'm so sorry you have had to go through this twice.
Unfortunately I've had a few now, and several ERPC's...

The last time I insisted on going through the chances of complications with the surgeon before agreeing to the procedure, and the chance of scarring was between 1 and 2 percent- which was lower than the chance of scarring being caused by an infection if the miscarriage was not completed.

....30% sounds ridiculous to be honest....if it was that high the NHS wouldn't be allowed to do the surgery except in life saving situations.

I think the paper you have read might not be accurate.

In terms of bleeding, no I don't think it sounds like enough...if you were 7 weeks but hadn't had an earlier dating scan, I wouldn't be worried as things could have stopped at 4+ but just taken a while to start, in your case as you had a scan in week 7 showing a HB, things had clearly developed....

I've had one where it has been incomplete and the cervix has closed again and so an erpc was necessary....

But i've also had one where not much had come out, and they scanned me and found that all the material had got through the cervix before it closed, but had dammed up coming out and was all stuck waiting to come down- they said leave it a week, it will come out, and about 5 days later it did....

I've also had one where I bleed for two hours and then nothing and they scanned me and it showed everything had come out all in one go, so nothing left.

So really I think you need a scan to check the situation, as otherwise it is difficult to know which of these senarios you are in-

I would be tempted to GO IN on Monday morning & ask to be scanned. (It is much harder to fob someone off in person than on the phone).

My thinking is things will close down a lot from Tuesday onwards, so you need to get yourself sorted out before this happens. If they object, haven't got a slot etc I usually just say 'look, emotionally I just can't take being in limbo for a week in this state' and they do have compassion and squeeze you in, even if they think 'medically' you are safe to wait it out.

Terrible timing for you, I hope 2014 is a much brighter year for you

Your experience is very similar to mine.
Ask to be rescanned.
FYI, I was 40, second pregnancy, dd is 5, medical management failed, I had an erpc and got pregnant the first month we tried. Ds is now 7 weeks old.