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Miscarriage/pregnancy loss

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Empty, ginormous sac on scan

11 replies

DieCryHate · 23/04/2019 19:19

Hello everyone. I'm supposedly 5+5 and went to EPU for a scan today. I stupidly thought I'd be fine as it was related to some pain I had over the bank hol which didn't amount to much other than a spec of spotting.

I apparently have a very large (33x24x11.5mm) and irregular sac, with no identifiable yolk sac or fetal pole. It didn't show as black on screen either, but greyish colour. Sonographer said there was something in there but worded it in a way to suggest she really doesn't think it's something that should be there. She said it could be blood or tissue breaking down. In her words "she's worried". They didn't tell me what measurements they diagnose by but good old doctor google tells me in the UK if a sac has a mean size of 25mm with nothing in it it can be diagnosed as a MC. Mine is 22.8mm.

I have to be rescanned in one week to check it's not a viable pregnancy and the midwife said there wasn't a need to take bloods. We were told this in "the side room", the one with tissues, so that can't be good. I'm sure on my dates as I was tracking and using OPKs.

Not sure why I'm posting really, I guess it's because I'm impatient and I just want some answers now which I know isn't possible. I wonder what the chances are of a MC happening now? They did say it could happen in the next 7 days.

Sorry to those of you who have gone through this, and thank you for sharing your stories for newbs like me.

OP posts:
lemon255 · 23/04/2019 19:26

im new to the website, what do you mean by 5+5 ?

lemon255 · 23/04/2019 19:29

I had a MC last year due to a empty sac at 9 weeks, they said it was empty and to come back a week later but over the weekend the spotting got worse and my body was trying to get rid of sac naturally. I still went into EPU and they did an op as my bleeding didnt stop.

I have heard of other cases where they see an empty sac but then a week later they see a baby and the timing isnt correct. Just see what happens next week

DieCryHate · 23/04/2019 19:36

Hi @lemon255. 5+5 = 5 weeks and 5 days gestation.

Thanks for your post and I'm sorry for your loss. I know I need to wait until next week it's just difficult to get on with things while I do so. I am having some cramps this evening, I'm hoping this turns into something as id rather get it over with. I know I'll probably regret saying that though if it does start!

OP posts:
Tattletale · 23/04/2019 19:36

5 + 5 would mean 5 weeks and 5 days pregnant.

DieCryHate · 24/04/2019 12:56

Tentative bump to see if anyone has had a similar experience x

OP posts:
regularbutpanickingabit · 24/04/2019 13:00

To be honest, it could go either way. Just because you know your dates doesn't mean the fertilisation happened exactly to a textbook timing and so you might find that a scan in a week shows a fetal pole.
Or it could mean that sadly this is a miscarriage/missed miscarriage and you just have to wait it out.

Either way I really feel for you. I have been in that situation several times with a pretty much even split between happy news and sad news. The next 7 days will be so hard to get through but just try and distract yourself as much as possible.

It's a shame they didn't do bloods and you could try calling your EPU or GP to see if they can do 48 hour bloods to check your hcg levels. They are meant to roughly double every 48 hours early on and that could be another way to see what's going on.

Good luck.

patchisagoodpup · 24/04/2019 13:03

I had this, turned out to be a mass of blood and tissue. I opted for a D&C.

Sorry you're going through this Thanks

coconutlatte44 · 24/04/2019 13:33

Hi @DieCryHate,
I'm so sorry you're going through this. You'll find good company on this board.

I also had an empty gestational sac although I was nearly 8 weeks, and mine was smaller than yours at the initial scan (mean diameter 15 mm). I did a lot of research because I felt nobody was being honest with me about the high likelihood it was a miscarriage - both doctors I saw insisted "we can't say anything for sure until you re-scan next week." When I re-scanned, my sac had grown to a mean of 23 mm and still no yolk sac or embryo, so I opted for the surgical management. This was about a month ago now, and while it was a really rough time, I am doing better now.

I will share some of what I learned during my week of (somewhat obsessive) research, and I have to say that based on this information you should probably be prepared for a negative outcome - I am really sorry if this is in fact the case, and in reality there absolutely are "miracle" outcomes that happen from time to time, but they are a very small minority.

From "Guidelines for diagnosing miscarriage" by the Institute of Obstetricians & Gynaecologists in Ireland: "The yolk sac is the first structure often seen within the gestational sac and it confirms an intrauterine pregnancy. The yolk sac is first seen by transvaginal ultrasound when the mean gestational sac diameter is greater than 5 mm, and should always be visualised when the mean gestational sac diameter is greater than 7 mm."

According to this same paper, "A diagnosis of pregnancy loss may also be made if the mean gestational sac diameter exceeds 20 mm in the absence of a yolk sac or embryo."

The cut-off for diagnosis varies between countries and some doctors are even more cautious than others - as you have said in the UK they tend to have the cut-off at 25 mm - but with a mean diameter of 23 mm I would imagine there is very little hope of a positive outcome. A mean diameter of 15 mm is enough to be "indicative" but not diagnostic of a miscarriage. An unusually-shaped gestational sac is also indicative of a miscarriage unless there is a specific reason the sac might show up irregularly due to fibroids, etc.

The reason they keep us waiting in agony is to reduce the very, very small chance that a healthy embryo might accidentally have been missed due to issues with scanning, as they don't want to risk accidental termination of a wanted pregnancy, and by waiting a week they can be 100% certain.

I hope this is helpful in some way although I am sure it is not what you want to hear. I just remember being desperate for information so I wasn't hanging on to false hope.

Please let me know if you would like any other information about the research I investigated or if you have questions that are less practical in in nature as well!

DieCryHate · 24/04/2019 14:42

Thanks all for taking the time to reply, much appreciated. Thank you @coconutlatte44 for such an informative post, what you have written is pretty much what my thoughts are too. I don't really see how it could end up being good news at such a great size and odd shape/texture. I hope they can give me a definitive answer at my next scan on Tuesday.

I am glad things are getting better for you now. I think if it turns out to be bad news I would also like to take the surgical option if offered. Thanks again. X

OP posts:
VenusStarr · 24/04/2019 18:14

Hi @DieCryHate I'm sorry you're experiencing this. My experience is similar, scan at 6+6 showed a collapsing empty sac, likely bleed in the sac and amniotic bands. My sac measured 22mm so had to go back 2 weeks later as my hospital cut off was 30mm. I had no bleeding and on the second scan no sign of the empty sac but they did find a 5week pregnancy sac with yolk and foetal pole so back for another scan however I miscarried naturally in the mean time. It took just over 3 weeks for my body to miscarry and another 2 weeks for my hcg to drop.

Hope you're OK Flowers

DieCryHate · 25/04/2019 22:56

Thanks for your support you lovely bunch and I'm sorry we're all finding ourselves on this board at all. I've just started bleeding so I have my answer. Take care of yourselves. X

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