Missed Miscarriage - Surgical or Medical management?

[Lalalala77]

I was hoping to get a bit of advice from someone who might have had either a surgical or medical management for their miscarriage and their experience of either.

Unfortunately I got told today at 9 weeks that I have had a probable missed miscarriage, the heart beat was there last week but sadly not now, I need another scan next week to do the tick boxes but they have asked me to decide which route I want to go down for then.

They have given me the option of having surgical management under local anaesthetic or Misoprostol tablets. I am swaying towards surgical, as I am not sure I can continue the heartbreak through more bleeding, but the idea of it only being a local anaesthetic is freaking me out a little - does anyone have any experience of this?

Thank you in advance to anyone who replies and I am sorry you have also been through this!

I’m so sorry.

Ive had a few miscarriages and always went down the surgical route.

The downside is that you have the best part of a day in hospital, there is lots of waiting around (while nil by mouth) and you have a general anaesthetic

But for me, the plus side was knowing it would all be over without waiting around for hours waiting for it to start, and also it was pretty much painless

Thinking of you and hope it is resolved soon

I had medical management. And it was fine. Most of the heavy bleeding was over in half a day. When I lost my baby at 6 weeks I didn't even notice I passed it. I did with the 10week one which could be distressing to some although I weirdly wasn't upset by that specific aspect. (Obviously the whole thing is very upsetting)
Take care of yourself.

After going through one mc at home I chose surgical management for a subsequent two and it was by far the better option for me. It was all over quickly and I didn’t have weeks of bleeding and uncertainty like with the first. However mine was under general anaesthetic which was absolutely fine.

I had surgical. it was very straightforward. No pain or bleeding and was pregnant again next cycle with no issues.

I'm really sorry about your situation, all choices are crap.

Ive had 1 miscarriage, I opted for medical and it didn't work, got a second dose and also didn't work and ended up having to get surgery anyway. If I was to have to do it again and I pray to God I don't, I would opt straight away for surgical, I had very little bleeding after, recovery was fine. It was my first time in a hospital never mind under anaesthesia and I was shaking with nerves but it wasn't scary at all.

Whatever you choose I hope it goes smoothly, its the time after and the emotional fall out that is the worst I think out of everything

I'm sorry to hear this. I had surgical management in December. I'm on another group for TTC post miscarriage and anecdotally it seems those who opted for medical management had more issues with retained products which then delayed the resumption of their cycle etc etc. At least with surgical it's more likely to be done and dusted in one go. I personally was fine straight after the procedure - done before lunch, walked to the park in the afternoon, had no cramping or anything unpleasant, just some light bleeding for 3-4 days then spotting for about a week.
All the best!

So sorry to hear OP. I've had two lots of surgical management. Both times were just with local anaesthetic. In and out of the hospital within a few hours. For me it was the best option and at least I knew it was over and done with and I could just go home and rest. Wishing you all the best x

I'd defo go surgical. Sounds like you are being offered an MVA rather than a D&C. It's local anesthetic, but have they said if you are allowed to be sedated at all? I had booked in for surgical and planned to request conscious sedation but thankfully passed everything prior to the appointment. My friend had medical recently and had a really tough time with the tablets, she had really bad cramps, constant diarrhoea and rigoring. Then after all that she needed the MVA after as she had retained products of conception. She said the MVA was unpleasant but over in 10 minutes and she took headphones to block out the sounds. Then she got an US afterwards to confirm. She wasn't struggling too much emotionally but this was about 6 weeks after everything so she just really wanted to move on.

So sorry you are going through this, wouldn't wish it on my worst enemy.

I’m sorry OP.

I opted for medical management, at a similar stage to you. I wanted to be at home with my DH, and I don’t like hospitals.

The hospital advised only paracetamol as pain relief, which I think would have been barbaric really. Luckily I had some co-codamol at home - you can buy in chemist as lowish dose.

I did have to have two rounds of medical management that were two weeks apart, and the first one, where I lost most of it, took place over 3 evenings, always stopping and then starting up in the evening again for some reason.

Despite that, I would make the same choice again if in the same situation.

DH and I got prepared with painkillers and pads and tissues and bags (to put pads in as I went through a lot) etc and just kind of holed up together and watched tv, when I wasn’t walking around to help with the pain, and we stayed near the bathroom with him coming in only when I asked him to, and taking bags away each time or sitting with me when I needed him to.

Afterwards when it stopped he helped me have a bath, I know it might sound a bit weird but there was something healing in that experience that I wouldn’t have felt in a clinical environment. Everyone is different though, and it sounds like previous posters had what was right for them, with the surgical option.

I'm so sorry to hear of your lost baby. It is so devastating! 😥

I had 3 mmc's before finally having DD but I was also on infertility treatment to try and combat the medical issue. I had a general anaesthetic for all 3 and was kept in hospital overnight but this was 1992/93 and things are done very differently these days.

With one of the procedures I had to be readmitted a few days later as I had retained products but it was easily sorted.

Given my time again I would still opt for surgical but I do wish you well whichever you choose. 💐

If you get surgical, and have any issues conceiving afterwards, get a gynaecologist referral.

I had scarring from the surgical (apparently very rare) and had no idea and wasted another year wondering what was happening.

Best of luck with it all. You will be ok.

So sorry to hear this OP. I have had 2 missed mc but later on at 14 and 16 weeks and was only given the surgical option for this reason.

Take care x

Thank you all so much for your replies, they've been really helpful. Such an emotional time but I feel a bit better now I have a bit more information! Xx

This thread has really helped me. I'm down for surgery tomorrow for my second mmc but they are pushing me to have medical. I do just want it all over with and with minimal pain.

Hope you're ok @Lalalala77

Hi there,

I have gone down the medical management route. I was told on my 12 week scan yesterday that I had a missed miscarriage. The believe that there was no development beyond 7 weeks. A big shock and really upsetting for us as it was our first pregnancy. I’m in my early 30’s so I’m worried/scared that this will happen again the next time we get pregnant.

I would have done the surgical route I think if I was able to have it that day or today, however there wasn’t any availability until next week and tbh, I just want this to be over so have decided on the medical management as opposed to waiting for it to pass naturally as it’s been 5 weeks now.

I’m so sorry that you, and others on this thread are going through this, it’s truly awful.

I have had 4 miscarriages. Having experienced all options, I would advise the surgical route. Recovery was straight forward, bleeding minimal (compared with others) and I got my period back quickly, and conceived shortly thereafter thankfully.

Other options were equally incredibly traumatic and in one instance, almost fatal for me, so I could never in good conscience recommend them (although that word feels very wrong).

Very best of luck and my thoughts are with you all. X

I have unfortunately had experience of both and I found surgical the better option by far in terms of pain and blood loss. Best of luck to you and I’m sorry you have to experience this x

I had a GA and I would recommend that.

Hi OP, I'm so sorry.

I opted for medical/surgical intervention for a missed miscarriage (scan at 12 weeks but suspected that development had stopped at week 9 or 10). I went in very shaky (so much that my legs were bouncing up and down and I kept apologising to the consultant!). It was a local anesthetic and there was a nurse holding my left hand and my DP holding my right hand. As others have said, there was a fair bit of waiting around but then the actual procedure was about 20 mins and as soon as it was over I stopped shaking and felt such relief. To do the local anesthetic they did inject around my cervical opening (like a clock at 3, 6, 9, and 12) which I could feel as pressure/ache but by the time he got to 12 I couldn't feel anything.

The months after were hard emotionally but physically I bounced back immediately (went on a massive hike the next day). My DP's sister went for the tablets first for her miscarriage and it didn't work (but she had to wait for 2 weeks to confirm that it hadn't worked) and then she had to have surgical intervention anyway which meant it all dragged in for 4 weeks longer from when she had the initial sad news.

So sorry for your loss, it's horrific having to decide between equally horrible options. I had medical management twice and found it totally bearable and not awful both times. I was prescribed codeine and took that every four hours along with ibuprofen and paracetamol. I also had a hot water bottle. Both times the baby measured around 8 weeks. I took the pessaries at 9am ish so that I'd be feeling better by bedtime.

I'd say the worst cramping was just for abut 1/2 hr both times but manageable. I preferred it as I just wanted to be at home, the thing I hated most was all the hospitals and stress around that. I just wanted to be at home with the most natural process possible (given that none of it felt very natural). The first time I actually waited 2 weeks to see if the miscarriage started by itself. The bleeding stopped pretty quick both times although the second time, I had a bit of spotting and cramping every afternoon for a couple of weeks but it was nothing and disappeared after about 2 weeks.

Sorry for your loss op, I would echo lots of above posters and recommend surgical. I had the surgery in December for a mmc at 14 weeks and wanted to avoid the psychological aspect of delivering. I’ve also had 2 (earlier) miscarriages at home (happened naturally, didn’t need the tablets) and also have two dc. The surgery was fine - you are well looked after, minimal pain afterwards and the closure of it was helpful for me. I did bleed for circa 3 weeks afterwards but it wasn’t too heavy. Good luck whatever you decide x

Thank you for this post, I have a suspected MMC and need a re-scan in 2 weeks to confirm. Those would be the options on the cards if I don't pass naturally between now and then. Currently 7+1 but only seeing a very large yolk sac at 8.1mm (which pretty much means non-viable) and no baby / fetal pole. I'd be 9+1 at the confirmation appointment and I guess any surgery would happen the following week.

Hi OP,
Firstly I'm really sorry for what you are going through and really hope that at your follow up scan this was all a big mistake!
I had a MMC last month. I was 11 weeks and the baby stopped growing at 9 weeks. I decided to have medical management at home but really regret this decision. I wish I had a D&C, in my opinion it's too much to go through at home.

The pain and cramping was pretty bad, but manageable with codeine but you could potentially have a lot of blood for quite a few days which I believe is far lighter with D&C.

Hi @Lalalala77, I am so sorry to hear this. I am sending you all my love and strength. I had my second miscarriage recently (my first was in November and a complete one as I passed everything at home). As my second one was picked up at an early scan, I was given all the options and opted for surgical management. I couldn’t bear the thought of going through the first experience as I found it traumatic.

My consultant was great in the circumstances in patiently explaining each option.

I had surgery on Tuesday. I got there at 7am and had had the procedure by 9am. Whilst I was emotional before and after, the hospital staff were caring and sympathetic. A number of people spoke to me throughout and this helped out me at ease.

I have been more emotional the last couple of days and this could also be because of my hormones. I didn’t have much bleeding other than yesterday and this morning.

I’m happy to go through in detail what happened the morning of the procedure to now if you or anybody else would like that.

Wishing you all the very best xxx