Empty sac at 8+1 - advice/stories needed.

[VanillaOat]

Hi all,

I’m looking for some advice on how to get through this as I feel as though I’m having a really tough time:

2 weeks ago, I went for an early scan as I’d been bleeding over the weekend. I thought at the time I was 6+1 but the scan showed an empty sac, measuring between 5-6 weeks, so it would have been too early to see something. The bleeding was due to a hematoma which has since resolved itself. The EPU booked me in for another scan for the following week, with the hope we would see a fetal pole and progression.

Last week I went back at what I thought was 7+1 and was told that there was still no yolk/fetal pole, however the sac had grown and was measuring at 12mm. The nurses told me that it was unlikely that the pregnancy would be viable but that I’d have to go back for another scan in a week to be sure.

I’ve gone back to the EPU this morning for yet another scan and the sac has grown again. It’s now measuring at 18mm but it is still empty. In between the last two scans, I’d researched my options and was looking to go for d&c by the end of the week, so that it’d all be sorted and so I could finally get closure.

However, the EPU have referred my measurements to a consultant who has decided that I should be scanned once more! The nurses have told me that they disagree with this decision as they understand the torment I’ve been experiencing mentally and they do not have any hope that this will be a successful pregnancy.

It’s clear that this is not a viable pregnancy and I just find it so so unfair that I’m unable to move forward whilst this useless empty sac is still inside me. I don’t understand what the need for yet another scan is at this stage and the wait between scans is causing me so much stress. Why would they need 4 scans to be sure when there has been no progression, other than the sac getting slightly bigger?

Has anybody had any similar experiences and is there any glimmer of hope that this will be successful, despite the fact I’ve already had 3 scans?

I'm really sorry I can't give you any glimmer of hope but I have been where you are in sept. I started bleeding naturally two weeks ago as I had a previous D&C in June so didn't want to have another surgery so close to the last one so opted for natural management. I had three scans one private two with the EPU as hard as it is to keep waiting and going back the UK has strict guidelines on when they can diagnose a MC with an empty sac it has to be a certain size 25mm I believe or be getting smaller. I never reached this size but mine has started to collapse and get smaller by my last scan when I should have been 11 weeks so they could diagnose the MC. As hard as it is to keep waiting the doctors won't diagnose without being very very sure. I obviously did a lot of googling and forum reading between my scans as I'm sure you have and although a lot turned out to be a MC there were a few anomalies where a baby miraculously popped up about 10/11 weeks. If you need any company or have any questions or want someone to rant to just message im here.

Hi @VanillaOat
So , so sorry to hear you're going through this, it's truly harrowing to experience. I had similar - small bleed, scan showing empty sac no fetal pole and then a second scan with growth, and then they wanted a THIRD scan. It was so traumatic and confusing. I knew there was no baby but the staff at EPU said they needed to give 'every pregnancy every chance' which was very confusing for me as I then had a glimmer of hope that a baby might magically appear.
Sadly, in between the second and third scan I miscarried at home - my sac had stopped growing at 6 weeks I thought I was 12. Lucky for me it wasn't painful but the bleeding went on for a couple of weeks.
What upset me the most was that because of their policy I wasn't given much guidance or support for the miscarriage as it happened between scans. I also wasn't able to choose medical or surgical management which is what I would have gone for, instead it 'passed naturally '. Well it felt unnatural to me!
There is a good thread on Mumsnet somewhere 'practical steps for coping with miscarriage ' I think, that can give you an idea of what to expect and what you need. I bought loads of sanitary pads thankfully didn't have to use them all and some painkillers.
I hope this all made sense and so sorry you're caught in the system like I was.

@mummatara thank you for your reply and so sorry for your loss. It just seems so cruel that it’s been dragged out so long and I feel like they’re not allowing me to make decisions about my own body. I’m worried that I’ll go back on Monday and it will still be under 25mm and in that case, would they still refuse to offer treatment, after 4 scans? As an aside, what was your experience of the D&C like and how long did you leave it before trying again? I’m so so nervous.

@justsayso thank you for your reply and advice and I’m so sorry for your loss and that you felt unsupported during those difficult times. The nurse started telling me about all the different treatments on Monday whilst she was waiting for the doctor to authorise (even though he didn’t) and for some reason, she seemed to be pushing taking the pills as opposed to surgery. Based on other people’s accounts of natural and medicated miscarriages, I just feel as though d&c would be best for me, although there is a part of me that wishes my body would do it’s job and make the decision for me. It’s just all to much to consider and weigh up and it makes me so scared to try again, in fear of it happening in the future.

@VanillaOat I think after 4 scans they should offer some solution I don't think they would keep going indefinitely it's not fair for you. I had heard that it's usually confirmed after 2 or 3 scans but I suppose as there has been growth they wanted to be very sure. So I had a D&C in June and I had a very positive experience. I bled for only a couple of days after and it was just more fresh blood than anything so I think more to do with just having the intrusive op down there than anything else. I was up and about perfectly fine after about 4 days no discomfort. It did take a long time for my hcg to drop but it was probably quite high to begin with as I was 12 weeks when the MMC was confirmed. I got my period after 5 weeks and a negative pregnancy test at 6 weeks I ovulated the week after that and we fell pregnant that cycle. Unfortunately that is this current MC which was an empty sac found at a private scan at 8 weeks. This time I opted for natural management and I didn't start bleeding until what would have been 12 weeks. I'm 3 weeks later now and have stopped bleeding but keep getting odd days of spotting so currently back and forth at the EPU with blood tests and hopefully a scan to see if anything's been retained. I've heard a lot about the pills some people it works for and others it was a waste of time and they needed surgery. If it happens again for me personally I think I would just opt for the surgery

It's such an awful time and yes you feel so out of control don't you, like your autonomy and choice has been taken from you, which is made even harder because you've also had the pregnancy taken from you as well.
I was told they wanted to wait for 20 days between my 2nd and 3rd scan but I broke down in the horrible 'quiet room' they put you in and they agreed to bring it forwards by 10 days, but I miscarried anyway between then and the 3rd scan.
I think if you called and spoke to the ward manager or a senior nurse they might advocate for you to bring the scan date forward if you explain how distressing it is, I know that the nurse I spoke to was really understanding and explained that their policy had only been adopted this year and I wasn't the only person to raise concerns about it.
All I can say is that you have a new path ahead of you now, that no one who is TTC really believes that they will have to take, but there are many women who have walked this path and many more behind you. Nature may well take her course between now and your scan. In some ways I felt angry at my body and wanted the sac out of me as fast as possible, I couldn't (and still can't) believe I'd miscarried and not found out for 6 weeks. That doesn't make it any easier to bear so please take care of yourself and allow yourself to grieve. My experience has been a rollercoaster emotionally and am not out of it yet I don't think.