RPOC of 1.5cm left. What now!?

[BlueFlamingo123]

Hi guys.

New to Mumsnet (and miscarriage support generally...). Really grateful for any help.

First pregnancy miscarriage identified at 12wk scan (blighted ovum).

MVA left 1.55cm retained product behind (rpoc). 2x medical management has failed to do anything. They are now saying "sit and wait" which is driving me mad as nothing is happening and I am desperate to ttc again (when my body is ready).

I know 1.5cm is the boundary of what they treat so my question is... What happens if they do nothing?

Will I have a period even with + preg tests (faint)?

Will it come out then?

Can I go back to normal cycle/fertility whilst it is in there?

Had anyone had a further MVA for such a small amount?

Help! Feel like I'm pressed pause mid-miscarriage and I don't know what's going on :'(

Hi,

Yes, you can still have a period with a retained product. The amount of hcg being produced is not enough to support a pregnancy or suppress a period. It's the waiting game. Have you contacted your gp to get your blood checked?. Think it will give a better answer on your hormone level and how fast it is falling.
All the best x

Hi Blueflamingo123

I am going through exact similar situation as yours. My pregnancy test is already negative though. I am scared about leaving it for long due to infection risk. And not getting confidence with another MVA as it was only 2.2 cm when I went for it, still they left 1.5 cm behind even after surgery. What happened finally for you? Could you conceive after it?

Hi Akan

Sorry you're going through the same thing. For that MC I ended up leaving it and it all went to plan and a few weeks later I had a period which seemed normal and after that a negative test. Not sure where it went!
I conceived again about 4 months later (unfortunately another MC but a v different pregnancy and managed to get further along).

I have had another MVA since where the RPOC was much greater and I did unfortunately have an infection and some heavy bleeding and so they booked me in for surgery under general, which i have to say was much kinder and much more effective than an mva!!

I think small amounts of RPOC can sort themselves out but obviously just keep an eye on it and always call up EPU with any concerns. Sending love x

Sorry for your loss. I don't think they'd do an MVA - it would be an ERPC under general, because (sorry) if this product hasn't come away through medical management then MVA will be too gentle.

Hi Blueflamingo

Thankyou so much for your reply. Sorry for your losses. Hoping to get a closure with next period. I am going through this for 8 weeks.

Hi Whataretheodds

Thankyou for your reply. I had SMM earlier not exactly MVA.

I was going from the info in your post.

hi all! I know I am quite late for the post, but I am in the same scenario now. 4 weeks after medical management with positive pregnancy test and 1.5cm retained product left. How did it go for you? Xx
thanks!!

Hi what was your outcome please? I am 4 weeks after medical management, and 2 weeks after a subsequent surgery to remove RPOC I STILL have a 1.5cm retained product and a positive test. I have a scan in 2 weeks to check if it’s still there and may need more surgery , what happened with you?

Hi @SarPea93 I am sorry you are going through this…I ended up having surgery plus hysteroscopy. Had negative pregnancy test after 2 weeks and period after 6. Hope all goes well for you 🙏🏽

Thanks so much for your reply. Horrible you had to have surgery but I’m glad it was sorted after that x

Hi sorry to bother you again but did you bleed for long after hysteroscopy?

Hi Ladies, I am sorry for you have been through this and for your losses on top.

@SarPea93 I am in a similar position to you, and I truly sympathise as it feels like a never ending nightmare doesn’t it?

I had an MVA for a MMC on 7th Jan, still had blazing positive tests 3 weeks after, was scanned and had RPOC so had a D&C on 31st Jan. I am now 11 days post D&C and getting faint, but still positive tests. I am due to be rescanned today to double check whether there is still any RPOC and find out what will happen from here.

Sorry that you’re going through this too. Are you still bleeding? They may suggest waiting for next period if not?
i ended up having a hysteroscopy on the 30th January and it turned out I still had 3cm of tissue. They removed it and also gave me medical management pills again to ensure it was all gone. But now 11 days later I am still bleeding which means it’s actually been 8 weeks of constant bleeding. It’s really hard to move on from our loss.
ours was actually a TFMR at 14 weeks due to our baby having patau syndrome. Apparently RPOC is very common when the loss is in the second trimester

I wasn’t up until yesterday, where it started again but seems to be slight spotting again this morning. I think I will have to wait to discuss following my scan but it least it’s today.

In relation to the blood loss, I was recommended on another thread to take iron supplements due to the length of time bleeding so I have started to do this. Maybe you could look into this too? It obviously won’t stop it but just so you don’t become anaemic. The other thing I have read on these threads is some ladies are offered medication providing there is no further RPOC to actually stop the bleeding, could be worth discussing with your EPU?

Oh I’m so sorry, that must have been so difficult to process. Sending love x

Ah that’s rubbish. It’s so annoying when you think it’s over and it starts again. hopefully you get some answers today. If it helps, if you do need the hysteroscopy I had no pain at all afterwards. It definitely wasn’t as bad as after the d&c

thanks for the advice - I’m on ferrous sulfate as I was borderline anaemic after the last surgery and they gave me pills to stop bleeding but as soon as I ran out of them (they only gave me a few days worth) bleeding restarted! I’ll give EPAU a call thanks

Hope you don’t mind me asking, but how positive were the tests you were getting after your first surgery? Mine are really faint now but obviously still there.. I don’t know whether with it being only 11 days since my last procedure whether that is a good/bad sign as they tell you to wait 3 weeks after the initial, but as my levels did drop after the initial even if only a little I was starting with less HCG so hoped they’d disappear quicker if all was resolved.

This is what my tests were looking like 2 weeks post d&c. I went for a scan the day after this test and that’s when they said there’s still tissue but we recommend leaving it 2 more weeks to see if it passes itself. 2 weeks later my bleeding was very heavy and the tissue was still there (the test was quite faint at that point though) but they decided to do the hysteroscopy. I think partly because we desperately need closure and we were just constantly back at the epau x

Ahh thank you. Mine are lighter, but from what you’ve said it doesn’t necessarily mean anything! We are similar with the trips back and fourth as this all started mid December but procedures were both Jan with scans and visits in between. I really want this resolving ASAP as we’re due to get married at the end of March abroad and with this on-going my travel insurance will no longer cover me and it feels quite scary to take that risk and having this still happening.. so I also feel like our wedding is at risk now!! When it started in December I really thought there’s no way it could affect that!

Aw what an absolute nightmare to be going through in the lead up to your wedding. I don’t know if it’s worth you looking into but I have just been away and we managed to get travel insurance through Staysure as they cover for pregnancy loss (and any hospital admissions related to this). Really hope it all settles soon and you can enjoy your wedding without this looming over you x

They are who I have contacted, thank you for the recommendation!! They have said they will cover me from the point of a negative test, which at the hospital today mine was as they don’t use the sensitive ones I have at home so I think they should cover me now.

My scan showed 1 tiny piece of RP left, but it was so small they wouldn’t intervene and are confident it will come out with my next period as it is no longer vascular and it isn’t attached to my uterus wall as it was previously. It’s just free floating. So onto the wait for AF now, hopefully she shows her face in the next month or so! X