Not sure which way to go from here

[TeaandHobnobs]

Hi
I'm hoping someone might be able offer me some advice/opinions:
I found out 2.5 weeks ago that my pregnancy wasn't viable - gestational sac measuring 7-8 weeks with yolk sac, but no fetal pole and no hb. A follow up scan nearly a week ago confirmed this, so I have a delayed miscarriage.

I have a GP appointment tomorrow, and as absolutely nothing has happened since the scan (no bleeding or cramping, just some brown discharge on and off) I feel like maybe I can't wait any longer.

I don't know if my GP is going to discuss the options with me, or if he has to refer me to the hospital - I was given leaflets at the EPU, but it is not my local hospital so it makes no sense to be treated by them.

I am weighing up medical management vs ERCP under local. Would anyone who has gone down either of these routes be willing to share their experience or let me know their thoughts/fears about them? I initially thought I would prefer medical management, but now I wonder if ERCP would be better since you can't tell how long things will take with medical management. But then again I was keen to avoid risks associated with a surgical option. And of course what if medical management doesn't resolve everything, and surgery ends up being required anyway?

Any advice would be welcome! Thank you

Sorry to hear you are going through this. I've had a natural miscarriage when it happened without any medical intervention and it was pretty awful, I had very bad cramps for a few hours then very heavy bleeding and I was sat on the toilet for about three hours. The pain and bleeding then settled to a more manageable level. I bled for over a month but I think that was because it hadn't all come away, as one night this big shrivelled bit of tissue came out then it settled down. I think medical management might be similar but if you are at the hospital they can give you decent pain relief.

The ERPC was far better, I had hardly any pain afterwards and no bleeding at all.

The ERPC didn't have any impact on me conceiving again.

I hope whatever you decide is okay for you, I'm sorry you are going through this, I found that once it had been 'dealt with' physically it hit me really hard emotionally, go with how you feel day by day for you

I'm so sorry you are facing this decision. It's a case of which is least worst for you, really. I've had 4 natural MC, one of which was incomplete and required medical management. The bleeding, clots and cramps are scary and unpleasant. MM increased the severity of contractions so if you go for this option ask for decent pain relief. I had effectively an ERPC procedure (with none of the emotional baggage) for retained placenta after birth of my son, and it was fine. I think the majority of posters choose this if it is offered, but it's not something I would want to be awake for. Offering it under local seems to be relatively new, unless there is a strong reason to avoid GA it's not something I would want to have memories of. I will bump up the thread about tips for coping which has lots of different experiences to help you make a decision. Good luck.

I had an early miscarriage at 5.5wks and didn't need any intervention. Was like a very heavy period with a bit of cramping. I was still at work so had other things to distract me.

A month ago, I had an ERPC under local after a MMC at 12 wks and I will never do it again if I'm unfortunate enough to be in that situation. Because I have a biology background, I was far too aware of what was going on and fully understood everything the dr and midwife were saying/doing. It wasn't sore, just uncomfortable and I bled for just under 2 wks after but not loads. I had reservations before the procedure about being awake and wish I'd just taken the GA. I decided not to in the end because of the quicker release from hospital and my little boy. I wasn't interested in MM and knowing/seeing that I'd passed the baby.

Emotionally, the latest miscarriage has been harder to deal with but only because I know I should've mc 6-7 wks before the ERPC. I did find the procedure hard at the time because I knew my baby had been sucked out and I should've been showing scan photos to people. (I also had an incredibly patronising and sickly sweet midwife that I wanted to punch the whole way through...)

I'm sorry you're going through this but although there are risks to every procedure, I think you have to take it all with a pinch of salt and and weigh up everything. The risks are small and it's rare that complications arise - they just have to tell you that the possibility is there.

Thanks all for your replies, I really appreciate it. And thank you bakingtins for bumping that thread, that has been very useful to read.

Saw the GP and he is referring me to the local EPU, so it will still be a while before I have to make a decision. He did say that it would be good to avoid surgery where possible.

I may feel differently later on, but I don't really feel that this was a pregnancy - knowing that it is just an empty sac, and having had a feeling right from when I thought I should take a test that something wasn't quite right, I've not felt too emotional about it. So it doesn't really feel like a "loss" in that sense? But that might just be how I'm processing things to cope - I have a lot on my plate emotionally at the moment anyway (father dying of cancer), so I don't think I could handle anything else.

Thanks again for your responses