MMC - surgical/medical/expectant management - wwyd?

[EffinIneffable]

I'm 8 weeks pg, but scans show no embryo. Looks like no development beyond 5 weeks (my dates aren't out - I am an obsessive tracker since ttc from Feb 2013). I haven't mc'd naturally yet, so next week will prob have option of medical or surgical management.

For those of you with experience of this, what would you do?

I'm leaning towards surgical management (ERPC) because it will be over and done with more quickly, and hopefully less bleeding afterwards than medical management.

We were supposed to be going camping week after next, and think I'm more likely to be bleeding too much for that if I go for medical management than surgical. Also I want to get back to ttc as soon as possible so don't want to wait ages for natural mc to kick in.
BUT - additional risks with ERPC such as perforating the uterus, scarring higher risk of infection, that could further reduce fertility in the future.

I had a natural mc 6 months ago at 6 weeks, which was relatively (physically) painless, just like a very heavy period. But of course being a bit further on and having to have surgical/medical management means it could be very different this time.

[EffinIneffable]

To clarify - I was drinking only after it was clear that it was going to be a mc! - they just hadn't officially diagnosed it because the sac was still slowly growing. I wasn't drinking at all before that!

[Erica21]

Hi Effin,
It's a bit confusing where I am, but had dating scan at one hospital where they saw no HB, they then referred me to main gynae ward at another hospital to see the EPU doc on the same day for advice. He booked me for a routine ERPC the following weds (this was thurs) but I phoned back and pushed to bring ERPC forward to Monday. MC on the sat at home but was advised to attend EPU on Monday for ERPC as planned, where they did internal scan which confirmed retained tissue so that's why I had it anyway. Am wondering whether to still do HPT anyway just to confirm its negative. My hormones are all over the flipping place and now waiting for mother nature to return AF so at least I know what my cycle is doing... I guess you could ask EPU for internal scan to double check everything has gone? I didn't think the hospital would scan me after my mc at home, but we went into hospital on the sat with our tiny baby to be sent off for histology (sorry if tmi) and the nurse was really supportive and told me to come in as planned, even though absolutely none of this was shared by the hospital doc. Xxx

[EffinIneffable]

Thanks Tori and Erica. How are you both doing now?

Had a scan yesterday and they confirmed that it looked like a complete mc so hopefully no more interventions. As long as I get a BFN in three weeks that is. Feeling very weepy today and just had a big fight with DH, which feels like hormones as much as anything else.

Erica, are you outside UK then? Always a bit confusing with different procedure and protocols. The EPU here said to do a HPT in three weeks just to rule out tiny possibility of molar or retained products that didn't show up on the scan. I think it would be reassuring to see the BFN as then when you next bleed you can be totally certain its AF and not a delayed bout of mc bleeding, and if you are ttc again you would know you were pg again rather than still having HCG in your system hanging over from the mc. We are planning on waiting at least one cycle before starting ttc again. Have you had any results from histology? I feel a slightly weird about just chucking the sac I passed away in a bin, but there was no embryo, and they won't do any tests until it's a 3rd mc anyway.

[Erica21]

Hi Effin,
Yes me and dh have had a few arguments too, mainly as he's at work a lot and avoiding the issues... No I'm in Kent, issues with Maidstone and Tunbridge Wells sharing maternity services... Ridiculous IMO. Just had to google BFN but now totally get what you mean, I will do HPT just to be sure tomorrow as that's 3 wks since MC. glad you're scan was clear though. Think I will wait a cycle before ttc, although I'm hormonally all over the place, I do want to crack on and hopefully be pregnant when the due date comes round in feb, I think I will be able to deal with it better then... Hope you're ok, I'm struggling with hormones now and wondering when AF will rear it's ugly (or not) head! X