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Miscarriage/pregnancy loss

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Medical management of MMC - my experience

20 replies

ChipAndDip · 28/04/2022 22:17

Hi all, I found it really useful reading other people’s experiences of missed miscarriage and the various management options so I thought I’d share a detailed account of mine in case it helps anyone else.

For background: I found out I was having a MMC at 7 weeks, which was confirmed at a follow up scan 11 days later. After doing a lot of research I was ready to request surgical management but the EPU doctor gave me a very realistic overview of the risks, so we decided to go for conservative management to start with. After 2 weeks nothing happened and my follow up scan showed the sac was still high in my uterus, so I decided to opt for medical management, which I took at home yesterday.

To get prepared, I cleared my work calendar, wrote a mini handover and let my team know what was happening and that I’d be off for the rest of the week. Yesterday morning I got up and showered as usual, put on comfy clothes, put plenty of pads in my bathrooms and laid an extra blanket down on my bedsheets just in case.

I took the misoprostal vaginally at 9.15am and then laid on my bed and had breakfast and coffee and took 2 ibuprofen. About an hour later I started getting bad period pain type cramps which were as bad but no worse than the worst period pains I’ve had before. A hot water bottle helped a lot. At 11.15am I took a codeine and there was no change until about 1pm. At that time I started getting more intense cramps every couple of minutes which I assume is when my uterus started contracting. It was extremely painful but I was able to breathe through it. At 2pm I had my first gush of blood and then passed what felt like one round clot. Intense cramps continued and about 30 mins - 1 hour later I had another gush of blood and passed a lot more clots. I pushed twice and each time a significant amount came out. After that I immediately felt hot and light headed. I laid down and the feeling passed in about 15 mins. I took another codeine at 3.15pm. The cramps continued for another hour or so and then I had another lighter gush of blood and passed a much smaller clot. After that I fell asleep on and off until about 7pm and when I woke up I had no more pain and the bleeding was just like a normal period.

I slept well last night with no significant bleeding. Today I’ve had bleeding on and off but nothing too heavy and passed a few smaller clots. I’ve only had very light cramps occasionally over the day but no need for pain relief. I’ve been quite tired and have napped on and off but luckily I’ve had no other side effects.

I have a telephone appt with the EPU tomorrow to check on my progress. I really hope that this is the worst of it over and I can move on, but part of me is worried that it was all too easy and maybe it didn’t all pass because the intense part only lasted a short amount of time. Or maybe I’m just lucky and it worked exactly as it should have. There’s nothing I can do now but wait and hope for the best!

I hope my account was useful for anyone thinking about going down the medical management route - in my experience it was nowhere near as bad as some of the stories I’ve read and if I do unfortunately ever have a MMC again I would definitely choose this option.

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cocoforbes · 29/04/2022 10:25

Hi @ChipAndDip thank you so much for sharing but also so sorry to hear about your loss and the fact you are having to go through this experience ❤️

Just had a 7 week scan yesterday and our baby was measuring 6 weeks with no heartbeat. I am very sure I have dates right as I was tracking bbt and using a CBFM. We are have another scan in two weeks but preparing for the worst and I somehow just know it's over so am starting to think about my options if I don't start bleeding before the scan so reading about your experience is very helpful.

Let us know how it goes over the next few days, I hope that the worst of it over for you too 🤞xx

DarkCorner · 29/04/2022 10:33

So sorry for your loss Flowers. I also had medical management (twice) both times sounds very similar to your experience, not pleasant but not horrific. I got through the worst bit (worst pain was only around 1-2 hours both times) taking codeine, paracetamol and ibuprofen all together and a hot water bottle. Lots of netflix with DP.

Indianna2006 · 30/04/2022 09:12

@ChipAndDip I had medical management a week ago similar to your experience. Gushes of bloods and losing clots and tissue. I was sure it must be done.

went for follow up scan at EPU and there is still 2cm of retained tissue or blood clot in there. There not entirely sure what it is.

so I’ve had to opt for another round of tablets. Which won’t be as bad. But hopefully will clear the rest. They wanted me to just wait to see if it would pass itself. But may take ages for HCG to drop down so I wasn’t keen on that option.

ChipAndDip · 30/04/2022 14:56

@cocoforbes I’m so sorry that you’re going through this. I was the same as you - sure of my dates so was definitely preparing for the worst, but there’s also no harm in hoping for the best. I really hope that you get better news than me, but whatever happens you’ll get through it. For me that wait between scans was the worst emotionally and when I got the confirmation I had at least some relief that I knew what was happening. Wishing you all the best x

@DarkCorner thank you for sharing your experience and I’m so sorry for your loss. 💐Not pleasant but not horrific is exactly how I would describe my experience too. If you don’t mind sharing, how long was it until you got a negative test/stopped bleeding?

@Indianna2006 I’m sorry to hear you’ve been through this recently as well. I’m worried about the same happening as you. I hope that your second round goes as well as it can and isn’t too painful. 🤞 This experience is already so drawn out, I really hope that’s the end of it for you.

Quick update from me: I’ve had cramping and light bleeding on and off the last couple of days and last night/ today have developed an occasional sharp pain which could be something stuck in my cervix (the Dr said that might happen) or could just be some leftover soreness from the experience. I’m having a little push everyone I go to the loo just in case! Other than that I feel fairly normal. The hospital offered me a follow up scan to check everything has passed, which I’m happy about as I was expecting to only be scanned if I was still testing positive in 3 weeks. So next scan is booked for Friday, I’ll update then!

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Indianna2006 · 30/04/2022 15:09

@ChipAndDip I felt fairly certain I lost so much it must of totally worked. But clearly not. I think small retained tissue can be common. Which is very frustrating. Majority has gone. But tiny bit remains. But stops your body being able to adjust back to normal as quickly.

fingers crossed the second round works to clear the tiny bit that is left. Feel like I didn’t want to just wait and it was worth trying it again.

i was given good pain relief and didn’t find it too uncomfy so hopefully will be the same.

i will update on Monday on how it’s got on. Feel like I might know if I pass more tissue which is what needs to happen.

horrible how prolonged it makes it

ChipAndDip · 30/04/2022 15:18

@Indianna2006 It’s so frustrating isn’t it. The biggest shock for me throughout this whole process is how long everything takes so I think I’d make the same decision as you and do a second round of the medication. I know it might be too soon for some people but I’m ready to just reset and start trying again.

Keeping everything crossed for you that it completely passes this time round 🤞🤞

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Indianna2006 · 30/04/2022 15:26

@ChipAndDip yes same. I know how long it can take to get a negative test and that’s even after all the tissue has passed. So just trying to speed things along so it’s not so drawn out.

it seemed to work quite well for me. Just not 100%. So hopefully another full second dose surely should clear what’s left in there.

here’s hoping. Such an ordeal isn’t it. Feels a bit surreal tbh.

Took us 9 months to get this pregnancy too so feel a bit defeated now. A year in and back at the beginning. But on we plod

DarkCorner · 02/05/2022 09:33

@ChipAndDip hope you're doing OK today. The first time I think it was around 2 weeks that I tested negative. And the second time around 3 weeks. I tried not to obsessively test every day though and just go by how I felt. The second time, I had a bit of cramping every afternoon for about 2 weeks and sometimes a tiny bit of bleeding. I think it was just my body getting back to normal. Fwiw, everything worked out for us with the next pregnancy. I took 150 mg aspirin per day with that one and think (but will never know for sure) that it made the difference.

ChipAndDip · 02/05/2022 12:43

@DarkCorner Thanks so much for your response. I’m feeling pretty much back to normal already with just a light bleed and mild cramps every now and then. I’m planning on testing once a week - I’m good at not getting too obsessive so that should be fine for me. Appreciate you taking the time to respond 🙂

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ChipAndDip · 06/05/2022 18:17

Update: I had a follow up scan at the EPU today (10 days post medical management) which showed that the pregnancy sac has passed and my uterine lining thickness is fine, but I still have a very small amount of retained tissue. They gave me 2 options: wait and see or have surgery now. Because it’s such a small amount I’ve decided to wait and avoid surgery if possible. They think it will hopefully come away with my next period. If my pregnancy test is still positive in 3 weeks then we’ll need to reassess. So the wait continues!

@Indianna2006 how is everything going for you?

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Indianna2006 · 06/05/2022 18:39

@ChipAndDip hey. Sorry to see yours wasn’t complete either.

well my first medical management I lost a lot. Follow up scan showed retained tissue like yourself. Small ish amount of 2cm but was offered to wait. Try tablets again or surgery.

i tried tablets again but nothing happened. No more bleeding. So I ring them back. And they some come back in for another scan. So this was then 2 weeks post first tabkets and first bleed.
my pregnancy test was still very bold. And I kept having pain when I coughed. They scanned again and nurse was same and said it looked no different in that week. Even tho I’d still been bleeding this stringy brown stuff.

she then showed me on the screen. An said you got 13mm lining which is fine and may
come away. But could take weeks and weeks. And small retained tissue. But seem like quite a few clots.

she said as second tabkets didn’t work. And it’s been 3 weeks. I’d suggest surgery.

so I was booked in and had it today. All went well as expected. Little groggy when I came around.

but now bleeding fresh red blood again which is already tapering off and good news I think. As think left over remains was causing that brown stringy gunkyness which would of gone on forever.

and now when I cough already. That discomfort is gone. So fingers crossed they got it all. And in a few days I feel much more back to normal.

just so you’re aware my surgeon and nurse said to me today if you have this again. Just go surgery. Medical often doesn’t work totally and ppl end up here anyway.

an they said leaving people to wait for it to clear in a period. When it hasn’t cleared properly after 2/3 weeks only works in 2/10 people. And the other 8 end up in surgery just weeks further down the line.

just something to bare in mind. The watch and wait approach can take weeks and months. And for some people doesn’t ever actually work. But understand every person is different in what choice they want to make.

after 4 weeks. I wanted to be able to move on and not bleed for another 4 weeks and end up with surgery anyway or an infection.

it’s just a nightmare where no answer is right. Hope it resolves for you. X

ChipAndDip · 06/05/2022 19:41

@Indianna2006 So sorry to hear that you’ve had to go through all that. Interestingly my Dr told me there was no point in taking the tablets again as you have the same chance passing it naturally as you do taking the tablets, so it makes no difference. I found that really surprising. Seems like the advice varies slightly depending on who you talk to.

I totally understand why you opted for the surgery. I actually almost opted for surgery right at the start but my Dr put me off! It’s so difficult deciding what’s best. I know there’s still a chance I’ll need surgery but for now I feel very healthy, I haven’t had any pain or bleeding for about 5 days and I just want a break from having to go to hospital to be honest! If nothing else at least I’ll hopefully have 3 weeks of normal life.

That sounds like good news that your pain has already gone, hopefully it stays that way and you have a speedy recovery and can move forward soon. What a bloody nightmare for us both x

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Mummyof4Ireland · 09/05/2022 11:00

Thank you for that detail. I'm currently in hospital waiting for a bed to start the process. Found out a week ago baby had no heartbeat at 15+2wks and I haven't a clue what to expect once they start me. This would be baby #5 so I've had 4 previous labour's so the pain side doesn't annoy me just the "passing" of the baby. Sending you healing hugs

Indianna2006 · 10/05/2022 09:05

@ChipAndDip I tested a few days ago and still had a fair line on a pregnancy test. Tested yesterday and it was much fainter. I think I’m couple days it will be negative!!

which is a relief. And exciting as I may ovulate not much after and we can get going again.

we’ve decided not to wait and gonna try catch ovulation this cycle. 🤞🏼

ChipAndDip · 10/05/2022 19:44

@Mummyof4Ireland I’m so sorry for your loss. I hope everything went as well as it could yesterday and you’re now back home resting up and taking care of yourself x

@Indianna2006 sounds positive that your tests are getting fainter 🤞 I really hope you get your negative soon (followed quickly by a new positive!) I’m still testing positive, but going to wait another week before I test again. I still haven’t had any more bleeding or pain so hoping that’s a good sign 🤞

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ChipAndDip · 27/05/2022 17:59

Hi all, thought I’d share a final update for any future readers. Today was my deadline for reporting my pregnancy test result to the EPU and exactly 1 month after my medical management I finally have a negative test! So in the end I only had the one round of medical management with no need for surgery so I’m pleased I decided to wait.

EPU have said my next period will likely be heavier/longer/more painful than usual (joy!) and will arrive any time in the next 4 weeks. They advise waiting for a period before TTC again but there’s no medical reason to wait.

Wishing all the best to anyone else going through this x

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neverwakeasleepingbaby · 27/05/2022 18:19

Good luck OP! I had two miscarriages (both conservative management) before having my son last year. It was a tough time but we got through it. Hope it works out for you in the near future

Indianna2006 · 29/05/2022 11:53

@ChipAndDip that’s good to know you now have a negative and all is done. What did you sue to test for negative?

i only ask because I got a negative on Strip test 20mui sensitivity 2 weeks ago. I ovulated soon after. Due period any day.

tested again. Strip test is still negative. I have a positive frer. But there so so sensitive. I think it’s possibly residual hormone. As strip test today was still negative and no change in rise.

2 weeks later and hcg hasn’t dropped from 20mui to below 6.5mui which is what frer detects?

ugh it’s so confusing. And everyone says you can’t ovulate with hcg in system. But I did! Clearly!!

ChipAndDip · 29/05/2022 13:01

@Indianna2006 In the end I did a Clear Blue digital with weeks to confirm the negative, which are sensitive at 10mui. For a couple of weeks before I was getting squinters on 25mui tests which I think were probably negative or near enough but couldn’t be sure, which was why I decided to do the digital. I only did one at 3 weeks and 4 weeks post medical management so I didn’t waste loads of money!

One week before my negative I was still 1-2 weeks on a digital so probably had just 10-25mui of hCG left for a little while.

I also think I ovulated before my test went negative, or at least my body tried to! It’s all so confusing isn’t it!

I know it’s hard to wait, but if you test again in a week you should hopefully know either way 🤞

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ChipAndDip · 29/05/2022 13:01

Thank you @neverwakeasleepingbaby!

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