Missed miscarriage - next steps

[pingit]

I have had a missed miscarriage. Appt at EPU on Monday afternoon to decide which route to take. It's already been several weeks and it hasn't happened naturally so I would prefer intervention.

Can anyone share experiences of medical & surgical management please? I'm really scared of scarring and impact on future fertility from surgery but have heard many bad results from medical. Thank you

So Sorry for your loss. I have been through a missed miscarriage recently aswell. Sorry this will be a long read!

Although I opted for medical management it did not work for me and I had to have surgical management in the end so please bare that in mind. How far gone are you?. I should of been 12 weeks but baby had stopped growing at 10 and half weeks. Below is just my experience but I know a lot of others have had success with medical management so please don't let it put you off if its what you would prefer. In a way im kinda glad I went through both and i know I did everything I could before surgical management. I believe if you are measuring under 10 weeks your experience will most likely be different to mine as they tend to send you home after giving you the first lot of tablets.

I initially chose medical management as I could start that sooner than when they could fit me in for the op. I was in hospital as an in patient over night and had 3 x lots of medication the side effects are not pleasant sickness and diarrhoea... but I was given anti sickness ect. I eventually bled heavily after the 3rd dose and passed a lot of large clots but was not in too much pain, however the nurse examined it and advised none of it looked like pregnancy tissue. They advised at my gestation it should be easy to see the difference. I was examined by a Dr who advised he couldnt see anything and sent me home as I had been given the maximum dose they can give me , i was advised it could take upto a week to pass. Other than a few hours of heavy bleeding I didn't bled at all for the rest of that week. I was then sent for another scan which confirmed the baby was still there. The Dr then booked me in for surgical management but there was another wait of week before they could fit me in.

I finally had surgical management under general anesthetic on Thursday and was able to go home the same day. For me I have only had some slight period style cramps and moderate bleeding just like a period since. I was given a months supply of iron tablets but think this was low due to bleeding from the medical management, i was also given the anti d injection as im rhesus negative. Its still early days for me but the surgical management was rather straight forward much to my relief. I just now hope that I don't have any further problems but the chances are very slim.

Hi pingit,

I will share my experience with you. Tuesday I went to my local infirmary with my husband for our 12 week scan, there was no heartbeat & baby measuring 8 weeks 4 days. Due to there only being 1 sonographer at the infirmary on Wednesday, I had to go into the hospital for this to be confirmed again. Two sonographers did this at which point we the discussed which route I wanted to go down to manage the miscarriage. They discussed every procedure with me 1. Medical - I would basically do this myself at home, I had already decided before I went in that I did not want to do this. 2. MVA local anesthetic or 3. Surgical general anesthetic. I had thought I would take the MVA route but after a very long discussion I decided to go for option 3, I wasn't sure how I would have coped with the MVA although I wouldn't have seen directly what was happening, I personally felt it would cause me trauma being awake for that and as it was my first pregnancy. The staff were really calm and didn't force me in any specific direction, they also didn't put pressure on me to decide that day. I did however and I was told to come back into hospital for 8.30am on Thursday, due to covid there were no planned theatre lists so I wasn't sure if I would even be seen that day.

8:30 - I arrived at the Gynaecology ward, I was given my own room, changed into a gown (husband was with me in room).
09:00 - Nurse came round and inserted two pessaries to soften my cervix.
09:30 - I was taken down to main theatre on the bed, booked in (I was hanging around for a while as the nurses in the gyny ward hadn't signed my paperwork correctly or given me a band so theatre staff were not happy) whilst I was waiting the theatre staff were really lovely speaking and keeping me calm because I was very nervous. I was then moved onto another trolley and the consultant came around to discuss the procedure and I had to pick which type of anesthetic I wanted to go for, I choose to have the spinal anesthetic. I kind of had no clue re time at this point.

I was then wheeled into the anesthesia room, there were two staff plus the consultant. Consultant had to our in cannula into top of my hand but due to me having bad veins this wasn't nice. They tried in my left hand didn't work, then my right hand didn't work, so they ended up having to use my vein on underside of right hand. I will admit that was very sore but I just gritted my teeth under my mask. Once that was done I was told to go into a cat like position, on my side knees up pushing my back out and they did the spinal anesthetic, this was sore I won't lie not the most pain I've ever felt but it was uncomfortable and I did shed a few tears but the staff were reassuring talking me through everything and constantly checking I was okay. I then felt an instant warm and tingly feeling running down my legs which made them numb, they asked me kick etc to make sure everything was numbed correctly. I then remember them putting something through my cannula and the honest truth is I remember nothing after that, not one bit. When I woke, I was suddenly in the theatre resting area, my body was shaking uncontrollably must have been something to do with the anesthetic, they put this blanket on my if was like the packing you get inside a box, there is a hose attached to a machine and it basically blows warm air into thvacuume packed padding. I have no clue at all how long I was down there I reckon in total a good two and half to three hours. I had observations etc done and there was always a nurse by my side speaking to me. I was then wheeled back up to my ward & room, the nurses came round and did their usual observations a lot checking sensation in my feet legs, blood pressure, temperature. I also had had a catheter fitted when I was in theatre. I was given some soup and my husband had bought me some snacks from the shop so I ate those and then my catheter was removed. I had to call the staff in at one point to clean my up as I had been bleeding so they changed the bed. Nurse told me I needed to go to the toilet on my own, this was hard as I had been fasting from 10pm the night before so hadn't had anything to drink or eat at all that entire morning. When I returned I was also numb from the waist down so didn't feel like I needed to pee this did wear off pretty quickly. I made sure I drank a whole jug of water and a bottle of coke, I think around 3pm I eventually needed the toilet did a good amount (so I was glad as I just wanted home at this point) and then she told me I needed to go atleast another two times before I could be discharged and it probably wouldn't be before 6pm. My blood pressure etc was being taken every hour, I also had to have a Anti D injection as I'm Rhesus Negative and an injection for blood clots as the socks they told me I needed to wear for two weeks didn't fit (I have large legs). I drank another jug and half of water and did manage to eventually pee twice. I was discharged at 6.20pm that night.

I was told bleeding may last up to two weeks and will resemble a period. Two days later, I've had minimal bleeding resembling more like on the second last day of you period ending, occasional cramp today (but I also think I'm constipated sorry TMI so don't think that's helping). No pain downstairs, doesn't feel like I've had anything done at all. The only pain I am experiencing is in my lower back and that's because of the spinal anesthetic so I've been taking Ibprofen to try and manage that. One thing I was really annoyed about was that on two occasions I was asked if I wanted contraception. Once on the wendesday when I was discussing the management types the consultant asked me if I would want coil fitted (I'm assuming because they could have done it at the same time) I declined and explained I didn't want to be on contraception as we want a family. I was also then asked again by my discharge nurse if I wanted any sort of contraception home with me to which I again declined and explained that we want to try for a baby again but we are aware this will not be a straight away thing and I will give myself time to heal. I'm not sure if that's standard procedure, I've spoken to a few other woman on forums who were not asked but I also know a friend of a friend who was given contraception to take home even though she didn't ask for it. It actually really upset me when they kept asking because in a way it made me feel like they though I had gone through the procedure out of choice and didn't want another baby, which obviously was not and is not the case.

Sorry that was a really long response but I hope it helps atleast a little bit.. If you have any questions let me know and I will try to help xx

@pingit I had an MVA following our 12 week scan and finding out the baby stopped growing at 8.5weeks. Surgery under general anesthetic wasn't available in the UK due to covid so my options were let it happen naturally, take the tablets to help it along on MVA which is done under local. The procedure was ok sore but not too bad and I was tender and felt bruised after but all and all it was ok. Sadly I had retained issue after this and ended up going through a natural miscarriage anyway. I dont think there is a right option its just what works for you and no two cases will be the same. I got a blockage of tissue in the neck of my cervix and had to get it removed at hospital, that pain was 100% times worse than the MVA but as I say no two people will have the same miscarriage.

You just have to decide whats right for you, miscarriage is painful emotionally and physically. I went for the MVA as I wanted it over quickly, didnt work out quite like that but had it worked it would still be my preferred option as passing the tissue naturally can be quite distressing

Just do whats right for you

I'm so sorry.

I had medical management initially. Bled very heavily, it became an emergency, ended up with surgery on the middle of the night. Quite a frightening and overwhelming experience. That's my experience- I hope whatever route you go down will be a bit smoother

Hi @pingit sorry you are going through this, I have just had my 3rd miscarriage and my second MMC. For this one I was 12 weeks but the baby only measured 7+4, I hadnt had earlier scans so we dont know at exactly what point things went wrong. For my first MMC I chose and MVA which for me was probably not the best idea. I am very squeemish and have a tendancy to pass out, it was quite uncomfortable and because I knew what they were doing I passed out 5 times during the procedure, my poor husband thought I had died as they all rushed into the room I was in and when they opened the door he could see me unconcious on the floor. I would add 4 other women went in for their MVAs and were in and out in 10 minutes so if you arent weak willed then this is probably a good option.
This time i decided to go natural, I read about doing medical but the other side effects really put me off, a natural miscarriage is difficult enough without feeling sick and having diarrhea to boot. I had my scan at the hospital on Tuesday and at this point I still had zero signs of a miscarriage, no pain, cramps or any spotting. On Thursday at 6pm my waters broke...i felt a woosh while i was cooking dinner, then i had nothing until 4am when i woke up and had to run to the bathroom where I am not going to lie it looked like a horror movie. I was then awake from 4am to 8:30am with contraction like pains and heavy bleeding. At 8:30 am i passed another very significant amount of blood and clots, I very nearly passed out but held it together. I called epu as i was concerned by how much blood i had lost but i held off going into A&E as my blood pressure was still ok (I got a monitor on amazon). I felt like death yesterday (anaemia i think) but by yesterday evening I was feeling much better and the bleeding was normal from lunchtime and now is like a normal period. I havent had any cramps or pakn since yesterday afternoon. All in all it was traumatic (it always is no matter what you do) but Im glad i let my body do its own thing this time as I feel ok now.

Thank you all so much for sharing your experiences. I'm sorry you have all been through such painful situations, and I'm really grateful you've shared them. It's really helpful to hear them.

I should have been 8 weeks but measured 6.

@KM89 I'm sorry your medical management didn't work. I've heard so few success stories from it - everyone seems to find it doesn't work and need surgery anyway, but I guess that can't be representative as they wouldn't offer it so much if it never worked!

I am still feeling very nauseous and I just don't know if I can cope feeling that way for another 1-2 weeks until they could do surgery so I may have to go for medical and just hope it works.

I hope it works for you it does apparently have a success rate of around 85% and from what I've read those measuring 6-8 weeks look more successful. Good luck with everything. Its not a nice thing to go through no matter what option you take xx

I had medical management following a miscarriage at about 11weeks. The process wasn’t that bad and worked ok (although it took about 3 months for my cycle to get back to normal). I was abroad (so May be different to U.K.) and was given the tablets to take at home. I took the first one and then took the second before bed. Woke up, when to the bathroom, painlessly passed everything and then went back to bed bleeding not much more than a period.
There is a really useful thread on here somewhere which talks about the practicalities of it, which I’ll try to find.

Sorry I can’t find the thread 🙁

The biggest plus for me with medical management was that I could time things for when it was convenient - in my case overnight whilst my other kids were sleeping- rather than risk things happening spontaneously whilst I waited for surgery.

@pingit how are you, did you go for medical management? X

Hi @KM89 thank you for checking in.

I am ok thanks. EPU did another scan and decided they needed to wait one more week and rescan before I can have any treatment.

The embryo had actually shrunk at this scan, and the sac had grown, but not enough for them to feel satisfied that I'm not just really early.

I know I'm not early, my dates are certain, and I had a positive test 5 weeks ago and should be 8.5 weeks now, where the measurements were more like 5weeks and sac was 6w6d. so I am frustrated to have another week of feeling sick and tired for no reason but not much I can do.

Rescan in Monday and then medical management. I am hoping it will happen on its own before then but it's not looking likely.

@pingit. Oh no how frustrating you have to wait but at least they are doing the right thing and checking again with another scan first. Hopefully things get moving soon for you 🙏. I know how awful it is playing the waiting game