Surgical or medical management - advice needed

[BluebellsRoses]

I've seen how lovely people have been about responding on this topic.

I should be 13+ weeks pregnant but although I have an amniotic sac it contains only a tiny dot. So I had an MMC quite a while ago. I'm bleeding, but not much, so expectant management is ruled out. I've had my second scan so I now need to decide which intervention to go for.

I have one DD (3 yo) and had gas and air followed by nothing during my induced labour with her. I was screaming the whole time. I don't want a lot of pain again, and I hear medical management can really hurt. I'm primarily considering the surgery under either local or general. But I'd be interested in people's thoughts and experiences of medical management and the two types of surgery.

I'd really appreciate it!

I’m sorry for your loss ☹️

I had a missed miscarriage nearly 4 weeks ago. I chose to have medical management which seemed to work really well, but I ended up having retained products 2 weeks later. Had the medical management again but it didn’t work, then had it a third time and it didn’t work again. So I had to have surgery on Monday.

I’ve read similar happen to lots of people… if I was to go back in time, I would have picked surgical ☹️.

However, I didn’t find the medical management too painful at all, it just wasn’t successful for me ☹️. Dr said it fails in 1 in 20 people so I guess I was one of those.

Good luck with whatever you choose.. I’m sorry you’re in this position - it’s heartbreaking 💔

So sorry for your loss. I had medical management for my first pregnancy - I also found out the baby had stopped developing when I was 13 weeks along. For me, the experience wasn’t successful initially as I had retained products, though I ended up passing them naturally 2 weeks later at home. I wasn’t prepared for how emotionally traumatic medical management wound be - seeing the baby when I passed it and being alone in the hospital toilet with it. However in hindsight I am glad I did get to see it. I have heard on here that people have spoken more favourably of surgical management.

I had surgical management of my MMC today. Bit of cramping now but not too much pain. I have a little bleeding but not much. So sorry for your loss.

I should say I had a general anaesthetic and that was fine.

I had surgical management because nothing was happening at all and I wanted it over quickly. It was extremely straightforward and I had no pain at all.
No point physically suffering as well as emotionally suffering imo.
No experience of medical management though. Sorry this has happened. It’s shit

I'm so sorry for all of your losses too, @Holly0609 , @KatieJ345 , @Longbarn5 , and @toomanyleggings . I'm sad miscarriage is so common, however comforting it is to have so much support from those who understand. I was completely shocked when there was no baby on the ultrasound - it is devastating.

I'm really sorry that you had retained products and ended up needing surgery anyway @Holly0609 . @KatieJ345 that sounds harrowing, although getting to see your baby is so special. I took a picture of the scan (technically I wasn't supposed to), and that is precious to me as the only "evidence" of the baby that I have. 😢

Thanks very much for sharing all of your experiences. I'm going to go for surgery with the general anesthetic, and hopefully it'll go smoothly.

@BluebellsRoses I'm so sorry for your loss. I had a miscarriage in September and decided to have surgical management (under GA - my local hospital offers MVA under local but the consultants who do it were both on annual leave so I would have had to wait quite a while to have it). It was distressing at the time but that was inevitable given the situation - but I think overall it was better not to really know what was going on and to have some reassurance that the risk of retained products would be minimal compared with medical management. I also didn't want the fear and worry of having to go through it at home (and I thought my husband would find that really hard as well), and appreciated the fact that the procedure took place in hospital and I could go home to rest and recuperate afterwards. My procedure went completely according to plan, minimal bleeding during and afterwards, I had some mild cramping in the couple of hours after waking up but otherwise very straightforward.

One thing to mention, which I was warned about but couldn't really prepare for, was that there was a huge hormone crash about 48 hours after the surgery, so on day 2/3 afterwards I felt absolutely awful and was an emotional wreck. There wasn't really anything I could do about it apart from ride it out, but being warned about it first at least gave me some reassurance that I wasn't suddenly going crazy - so if you have something similar then you know it's totally natural and not something to worry about.

I really hope the surgery goes smoothly for you. Take care.

I've had all 3.

1st pregnancy I bled a LOT and had had a lot of pain but hadn't passed the sac and all the tissue so opted for medical. I passed some more - yes it was painful (I've never given birth so not sure how it compares) - I did it in hospital so had morphine, thank goodness.

That didn't finish everything off so I ended up having an ERPC under general. Was quick and easy and after 4 days in hospital a relief to know the physical stuff was done. Minimal bleeding afterwards and I didn't need any pain relief after the GA wore off.

2nd pregnancy was MMC, no bleeding, opted for MVA mostly for scheduling reasons. Was also a bit nervous of the ERPC a second time in case of scarring.
Day case, in at 8am, out by 1.30pm. uncomfortable when they insert the local aneasthetic and then for about 10 mins during the main bit of the procedure. Some cramping afterwards (manageable with ibuprofen), I felt generally more fragile, bleeding for a couple of weeks I think.

For me the major factor was certainly of the physical loss being over so my hormones could get back to normal. I couldn't be doing with bleeding for weeks and feeling on edge waiting for the contractions and significant bleeding and clots to happen while out and about or work etc.

Worth asking to speak to the doctor who will perform the procedure and asking them how they will use US scanning during it.

Note - I've no reason to suppose my ERPC caused scarring: I got pregnant easily twice afterwards

@CluelessInLondon and @Whataretheodds , I'm so sorry for your losses too. 💐

Thank you for your condolences and this extra information. I didn't know about the hormone crash or to ask about the ultrasound - that was so helpful and I've asked about the US now. Clueless, I've seen you've responded to several people recently, which is so kind of you.

The surgery is scheduled for this week. I'm a little nervous but there's a good chance it'll be completely fine.

I'm praying for successful future pregnancies for all of us on this thread who will be trying again in future. God bless you all.

You're welcome: very best wishes.

@BluebellsRoses You're welcome, and if my experience can help anybody find their way through what is a really unsettling, confusing and upsetting time then I'm glad of it - it makes me feel like at least something useful has come out of what I went through. I hope the surgery goes smoothly this week and your recovery is quick - good luck and take care of yourself. ❤