Missed MC and medical management - please share experience/advice

[awakeatnight]

Hi everyone
I found out that my baby died. It was at the ‘12’ week scan but at 13 weeks by LMP, and they think baby died at 10 weeks.

I have to go in to the hospital for a confirmation scan and to discuss my options which I’ve been advised are to be surgical or medical based on gestation.

It’s heartbreaking. I feel like I’ve had the rug pulled from under me. I had no idea - no bleeding or cramping, and have been nauseous and getting fatter so it was a total shock.

As awful as it is to think about, please can any body share their experiences of the surgery or the pills? I’d appreciate any advice on what to expect before, during and after.

Thank you

Awakeatnight

I'm so sorry this happened to you, it's heart breaking.
I've had a few miscarriages, I had 2 surgical procedures & 1 medical management (taking a pill).
The first surgical procedure was fine. No pain, managed at the hospital very well. Second was a different story; I had to wait a couple of days for them to do it, then when it was done, I was in extreme pain for several days.
The third time, I opted to take a pill. I stayed at home with my husband, we watched a film together & the foetus passed that night. The worst part was the agony of trying to decide whether to look in the toilet (sorry TMI) or not. I felt I should look & felt guilty for not wanting to look. There wasn't really anything to see & afterwards felt silly for getting so worked up about it.
My memory of the last miscarriage now is more positive than having a surgical procedure. It was nice to be at home with DH, to have a day together feeling sad (I felt very cared for) and then no pain afterwards. I went to work the next day. Not necessarily the best idea as I was still bleeding but it helped me to busy my mind. Probably helped that this was the 3rd time it had happened.

I hope that helps.

Hi @awakeatnight

I'm so sorry you're having to go through this too. I found out at my 12 week scan on Thursday that I'd had a missed miscarriage & similar to you had had no bleeding or cramping and still felt pregnant though my symptoms on hindsight had dipped a little. Is an awful shock which I wouldn't wish on worst enemy. The pregnancy had stopped at 9.5 weeks. I was told by the early pregnancy centre that I could have medical mx, surgery or watchful waiting for up to 4 weeks max for things to happen. Though if I wanted medical management they told me I'd have to have it in hospital Vs home as the pregnancy was just over the threshold size wise at 9.5 weeks of it being higher risk of needing intervention (that might just be my EPU though). I'd opted for that as I didn't want things to drag out but was keen to avoid intervention (risks are very low but I just personally hate procedures generally & wanted to avoid it).
So I was in over the weekend for that. They gave me 800mg (4 tablet) under the tongue tablets of mistoprostal but it did nothing in 12 hours other than make me spot and mildly cramp a little. I then had another dose & waited 12 hours and that did absolutely nothing. So I then chose the surgery which I had yesterday morning. I have to say though the staff did say that what happened with me is very unusual & usually the process starts within 2-4 hours and is over by 12 hours. I also think from reading around that some centres use pessaries of the tablets which are maybe slightly more effective as they're acting more directly- I don't know.
The surgery for me has so far worked well though. I had a general anaesthetic was in early in the morning and back by late afternoon. I had some intense period pain cramps for an hour after the procedure but since then just mild period type pains and light bleeding. Planning to go back to work tomorrow.

This is my 2nd miscarriage and my first was natural miscarriage of a 6 week pregnancy at 8 weeks. This was over Christmas with my parents & husband for support & was overall a much better experience for me personally. I found passing & seeing the gestational sac gave me closure though you may not always pass identifiable tissue reading others experiences. I have to say though physically it was more tough (bit more than a heavy period and had a few hours of what I would call more contractions vs cramps)- though I think people's experiences vary with this too esp depending on how far along the pregnancy is.
I hope this helps. There are no right decisions on what is best with this process. It really is a personal one on what you feel you can deal with the best for you physically & emotionally. Wishing you all the best on getting through this. XxxX

Thank you so much for sharing your heartbreaking stories. Sorry for the slow response - have just been laying low.

I went in on Wednesday and had the loss confirmed again (grim!). It sounds very similar to you so far @jessabean, I was offered the same options for my 10weeker. I’ve opted to go straight for surgery as the tablets were going to be on a gynae ward over a bed pan, and they advised that an overnight stay was a distinct possibility. This sounded awful to me plus I have a one year old so the unknown factor of how long it could take worried me for her sake too. For what it’s worth, if I could have done this at home I would have done it that way.

The surgery was scheduled for Tuesday so a week after finding out about the loss and 6 days following hospital confirmation. Could be a long day - in at 10 for bloods etc and on the afternoon list.

I’ll update this once I’ve been through it for anyone else reading for advice in future.

For now I’m trying to keep busy (the one year old is helping!). I wish I felt numb - it’s mentally too painful for that. It’s like standing behind a pain of broken glass. My body defiantly still thinks it’s pregnant and the nausea is really getting me down. Such a kick in the teeth!

Anyway, stay strong lovelies. X

I'm very sorry for your loss. I've had 2 missed miscarriages and I found the surgery much less traumatic than medical management. Particularly at your gestation, I would think surgical management would be the better choice. I had medical management at 9 weeks and it was very much not like the heavy period the doctor said it would be.

Sorry had not realised you had updated. Good luck with the surgery, hope you have a quick recovery.

It sounds like you made the right the right choice with the surgery. Especially if was anything like my experience at least this way it should not prolong things further & that way and you can be in a bit more control of timings for managing care of your little one.
I hope all goes well on Tuesday- I'm sure it will. I've found I've pretty much almost stopped bleeding & just a mild ache at times now. Just wish the pregnancy hormones would go now so I can try and move on a bit more easily - without constant reminder that I'm meant to be pregnant 😕
Wishing you all the best both physically & emotionally with the process. Here if you ever need any support. XxxX

Hi,

I had two failed medical managements for miscarriage last week which wasn't a pleasant experience and so reluctantly opted for the surgery which I had on Tuesday. It wasn't as bad as I was expecting. I have had three (different) surgeries before, so wanted to avoid another one, but I'm glad I did have this done now.

I'm not sure if you've had any surgery before, so I'm just going to write down what my day was like so you have some idea of what you might experience.

Before the op I had bloods taken, blood pressure checked and temperature taken and my medical history was discussed and the nurse went through the consent form.

Then I was taken to a ward and I was given a concoction of drugs to take: three or four pills to soften the cervix, two pain killers and two antibiotics. Being nil-by-mouth this meant drinking these down with one very small glass of water which was a bit difficult, but I managed it.

The pills gave me diarrhoea quite quickly and I felt very sick so was given an anti-sickness injection at the top of my bum (could have had it in the arm, but it hurts less in the bum because it's more fatty). This worked quite quickly so I felt much better.

I had a gown and some lovely disposable pants to put on and a massive sanitary pad which made me feel a bit like a sumo-wrestler.

The nurse told me the anaesthetist might come and see me, but actually the surgeon dropped by about half an hour beforehand to introduce himself and ask if I had any questions.

A porter then came to fetch me from the ward with a different bed. My partner was told he could walk down to the entrance of the theatre ward, but I told him to stay where he was as I felt this was the best option for us.

Not long after arriving at the "reception" area for theatre two of the women who were helping with my procedure came to fetch me and chatted to me as they took me in to the room where they put you to sleep.

I had a cannula put in my hand and a blood pressure monitor put on my arm and sticky pads put on my chest and they gave me and oxygen mask at the same time as injecting the anaesthetic, the whole time being very reassuring and chatting to me all the while.

I came round in the recovery room. A nurse was stood next to my bed checking the monitors I was connected to and told me where I was (if you haven't had anaesthesia before, it can be a bit disorientating when you come round so it's nice having someone reminding you where you are and why). I still had an oxygen mask on when I came round which they kept me on for about 20 minutes. I was told I might wake up with a drip, but as it happens I didn't have one.

I had some bad period cramping in the first hour, but that settled quickly.

I had a bit of a cry in the recovery room as well because it was very emotional waking up no longer pregnant.

By the time I got back to the ward I had soaked the pad they had put on me in theatre. A nurse changed it for me as I was still very groggy (and I think because it was also very blood-soaked), but the bleeding settled down almost immediately and became more like a regular period bleed.

They kept me on the ward for a couple of hours because my blood pressure was low, and a nurse helped me to the toilet in case I became faint.

Once my blood pressure was up again and I'd been to the toilet they took my cannula out and I was allowed to get dressed and go home.

I felt very tired for a couple of days and had some period-type pains, but nothing paracetamol didn't sort out and now four days later the bleeding seems to be stopping again.

I recommend taking something to do (a book, knitting, puzzles) because there is a bit of waiting around, and bring some nice thick cosy socks and slippers. They let me wear my socks and slippers down to the theatre and I woke up with my socks back on and my slippers waiting in a bag for me. Also bring tissues and a few heavy-flow sanitary pads and wear loose-fitting clothes that are comfy.

I'm so sorry you're going through this.

Look after yourself, take it easy and let us know how you get on.

Thanks all for your helpful and caring comments. I’m so sorry you’ve been through this too and wish you every thing in a speedy recovery.

I just wanted to add my story of the treatment. I opted for the surgical management.

I attended the early pregnancy unit at hospital to have bloods and do the consent forms. One that really floored me was being asked what I wanted to happen with the ‘remains’ - to be honest I don’t even remember what the options were or really what I chose, just sometime about ‘mixed’ internment and a memorial garden. I wish I had been more prepared for that.

After that I was taken up to the general day surgery waiting room and just told to wait for my anathetist and surgeon to come and have a word about the procedure.

I waited for hours, it was interminable. I was glad I had my iPad, portable phone charger and husband for company! Eventually spoke to a Nurse after waiting for 2 hours. She said I was last on the gynae list and that she’d come and administer the Misoprostol 2-3 hours ahead of my surgery time. Then came the anaesthetist who was very kind and knowledgable. More forms to fill in and more of the same questions about allergies, why I was there and what was going to happen. I spoke to a doctor after that who was very matter of fact, less kind and gentle than the others but fine. I had originally understood that the surgery would be done with a scan/camera so they could be sure they got everything but she informed me that it’s actually done with a suction device inserted through the cervix so they couldn’t guarantee getting everything. She also was less positive about how long the bleeding lasts, asserting I should expect up to 3 weeks whereas previous advice had been that they should get most of the ‘contents’ so to expect anything from short spotting to up to a few weeks of period type bleeding, of course with the warning to alert the GP for anything heavier or foul smelling or painful.

The nurse administered the misoprostol at 2pm and I had to keep it under my tongue for 30mins. It was gross and heartbreaking as it tingled in a burny way and I knew that was one of the final steps in getting rid of my baby. Didn’t taste of anything but left a horrid chalky feeling in my mouth. I was told to expect cramping abs bleeding to start so I put a sanitary towel on but nothing happened. I was worried it hadn’t worked and would prevent surgery!

Around 4pm I had a big wobble, I’d been in the hospital for 6 hours by that point and not eaten or drunk anything (bar a swill f water for the misoprostol pills) since 7am. It was hard and brutal I think to make someone wait that long!

At around 430pm I was finally taken through to the ward to put gown and stockings on and added my own dressing gown and slippers. Then i was walked through to the theatre room and climbed up on a bed where a cannula was fitted.

The absolute worst part was being asked to confirm what I was there for whilst lying on the bed. I literally couldn’t speak through the tears so the lovely anaesthetist held up my chart and said that I didn’t need to say anything, could I just confirm that she had my signed consent form and i understood what I had signed, and I nodded.

I had an oxygen mask placed over my face and it was explained that I’d be getting the anasthetic and some pain killers through the cannula. I remember breathing deeply for what seemed like ages, getting a bit dizzy and then feeling my arm tingle, then nothing. Then I woke up! I’d never had general before so had been terrified I’d either not wake up or wake up to horrendous news. I was told that everything had gone well, that I’d bled quite a lot but that it has slowed now. Apparently I’d also had a good sleep after! I just felt relief that is got through it. They gave me a small taste of water and someone came to chat to me a bit. We spoke about my one year old which was lovely that she’d found something out about me to talk about.

I was wheeled back to the ward where my husband was waiting. Nurse brought me a cup of tea and a plasticy cheese sandwich but it was good to have something to eat and drink, I wish I’d sent husband for a fancier sandwich!! My tests to go home were to eat and drink without being sick and to pee at least 200ml. Seemed to take ages to need to pee! When I did it was filled with blood which was scary even though I’d been told to expect that. I didn’t feel sick or unsteady when I got up so that was a bonus!

I was prescribed some paracetamol, ibuprofen and dihydrocodeibe to take home and offered some pads which i declined. Fortunately my bleeding has not been too heavy so have used some night sanitary towels and now in to regular sanitary towels which are so much comfier than the maternity style!

By 8pm, some 3 hours later than we had expected to leave, I was allowed home.

I ate a Marks and Spencer Mac and cheese ready meal which we picked up on the way home because I was craving it!! Watched some tv and fell asleep on the sofa before 10pm, went to bed and had the first full night’s sleep in over a week!

So the D and C seems to have been the right choice for me. I spoke to two friends that has tried the medical management - failed for both and proceeded to surgical which they felt much better about.

One more thing was that my GP was fantastic. This morning marked the end of my one week self sign off. The GP accessed my notes, said sorry for my loss and asked how long I wanted. I suggested a week at first and she agreed but said to phone back for an extension if I was unsure about going back to work. She also reminded me to book an appointment if I had any physical concerns or wanted to talk about how I was feeling. Glad to say that so far I’m pain free (slight crampy tummy but hardly even period pain) and mentally seem to be doing much better than before the procedure, though I am mindful that a hormone change is on its way. I’m looking forward to getting back to doing some exercise... and trying for another baby as soon as we can!

I’m so grateful to the ladies on this post and on this board more widely. It’s been such a help. I hope someone finds this useful too

awakeatnight I'm sorry you had to go through this and that it was such a long wait, but I'm glad for you that it's over now and you can begin to get life back to some normality.

Thanks for letting us know how you are.