An impossible question but which is ‘best’ medical or surgical management?

[Thorfire]

Hey MN

i had a mc in December and found out through bleeding so it was managed naturally. It wasn’t easy, lots of bleeding and pain.

Today I found out that I am only measuring 5 weeks but should be 8 weeks with an abnormal heartbeat. The odds look poor and the epu say it’s unlikely to be a viable pregnancy.

I am seeing the epu tomorrow for another scan but I want to know my options.

I don’t think I can do it naturally as the morning sickness is horrendous and psychologically I want it sorted.

Are the meds horrendous? I’ve heard some awful stories of women being so unwell and bleeding heavily from the meds.

on the other hand surgery scares me and I don’t know if I can face waiting to be seen.

If anyone has experiences they can share I’d be very grateful.

Feeling very low and lost right now

thank you x

So sorry to read your post. Thought I'd share a few of my own perspectives on this but everyone will be completely different.

I've had 4 miscarriages which have all been managed naturally - the first one was extremely traumatic and I bled heavily (I didn't know at the time this wasn't normal) and the others were much more manageable.

I also had a TFMR which involved taking the same medication as you'd take for a medical management of a miscarriage - physically this was fine and I bled heavily for a few hours afterwards but it soon calmed down.

Personally, I prefer the feeling of being in control from managing it at home myself. Unfortunately I think there's an element of having been through this enough times I'm confident dealing with it at home now.

I think I read somewhere that you can sometimes get scar tissue in the uterus from the D&C and it could make it harder for a future pregnancy to implant. I have no idea if that's true but it put me off of having an operation.

There's no wrong or right answer. Im so sorry that you're having to make this decision.

The only thing I'd add is that waiting around for your body to start naturally processing a miscarriage can be hard. For my last miscarriage I decided if it didn't happen by a certain day, I'd go to EPU for the medication (but it did).

Also, I've always been "lucky" and never had any retained tissue from a miscarriage but I think this is more common with a natural miscarriage.

I'm so sorry to hear you're now going through this horrible situation again, it's awful.
I had surgery for my MMC in February. I found out at the 12 week scan baby was measuring 8 weeks and had no heartbeat. I couldn't wait for it to happen naturally, I was in complete shock and petrified. Plus I already have a toddler so the dragging on if the medical route wasn't really an option either as I was told they'd recommend hospital if I wanted to do that and it could take days.

My surgery was booked in two days later and went seamlessly. I wouldn't hesitate to do this if the worst happened again.
I do worry about potential scarring but I think that's quite rare and I've got two friends who have had surgery and gone on to have successful pregnancies. The surgery is so common (sadly). I hope all goes ilas well as it can do for you in these circumstances 🩷

I had a MMC in Feb. I went for a MVA as did not want to be put asleep and where I am you could be booked in for a MVA. I found it painful but ok- the hardest part is when they remove the biggest part of tissues but then it’s ok. I would recommend , but I have seen on here people have had a tough experience with it too!

Sorry to hear you’re going through this.
I was also scared by the medication stories. However I took them first time one dose and then after no progress a week later I took two doses. They did make me feel sick with chills for awhile but nothing worse. And they did work in the end. Best of luck.

Very sorry to read this, it's a horrible stage waiting for the next scan too, I remember it well.

I had 4 MMC and despite saying before the first was confirmed that I couldn't face surgery, I quickly changed my mind upon reading that the meds didn't always work. Mine had been a twin pg and I was still being sick all day every day and no signs of anything happening naturally so chose surgery. It was quick and physically painless and I chose the same option for the subsequent mmc. I don't have any regrets about choosing the surgery.

I'm so sorry you're going through this.

I had a MMC last October (found at my 12 week scan, baby was measuring 8+4 with no heartbeat).

I ended up having two rounds of surgical management (there was retained tissue after the first), and as awful as the miscarriage was, the surgeries were painless and i had very little bleeding afterwards. They got me in for the first one within a week.

I would 100% recommend surgical management. The stories about failed medical management are pretty grim.

Oh and regarding the scarring, by the 4th the dr did warn that there was a slight risk but I'm delighted to report that since the 4th surgery I've had two successful pregnancies so it didn't cause me any issues.

She only told me about this once I was gowned up and about to be put under so it wasn't really the best time to get that message.

@ToBoneOrNotToBone it's reassuring to hear that you had successful pregnancies after so many surgeries. I'm sorry you had to go through all that. Going through he whole experience once for me was traumatic enough!

I’ve had 4 MMC and went for D&C each time - the 2nd one I tried to wait for it to happen naturally but became too distressed and they agreed to operate. I then went on to have 2 successful pregnancies so it certainly didn’t affect my chances to have live births.

Take care of yourself - m/c is such a misunderstood grief 😢

I should also add that after my second d&c in December, I'm now 9 weeks pregnant. The risk of scarring is low and the risk of it causing issues further down the line is even lower.

I’m so sorry @Thorfire
I had a MMC in November where I was meant to be 10wks but measured 8wks. I chose medical management which I did at home the next day. The pain really was awful, and at the time I said I’d never do medical again. But looking back now, I would choose it again. I was in the comfort of my home, and the worst of the pain was probably only 30 mins until I passed the sac. From taking the first tablets at 8am, it was all over by 3pm. Had no excessive bleeding & everything passed.
Theres no right or wrong, and everyone has such different experiences, so go with your gut xx

Sorry you’re going through this. I chose surgical under GA and I have no regrets, it was almost painless with only minimal bleeding. I did so because I was scared of dealing with pain and bleeding on my own at home. Wishing you all the best!

Hi all,

thank you so much for everyone replying. I’ve read every message and this has helped me so much.

So I had an internal and very different results from the private scan.

The baby was perfect measurements for 8 weeks not like the private scan saying it was only measuring at 5 weeks. The midwife today wasn’t impressed. So please don’t use private scanning, it’s really the Wild West.
They confirmed no heartbeat which was a relief as I wanted a definitive answer.
I’ve decided to go with the meds. Took the first pill at the hospital and come home to wait to use the other part of the meds tomorrow.
The midwives were very thorough and have put me on the referral list for recurring miscarriage ( not sure if I even want to go down the investigation route but it’s good to have the choice).
I was also given a two week sick note which can be extended if I need it.

I couldn’t have asked for more caring and supportive staff at the epu

The weekend is going to be rough but I feel a little more in control.

x

I’m a little worried but the reassurance is in the quickness of the process.

when I went through my natural miscarriage it took three weeks of which 10 days were the most intense crippling pain I nearly passed out!

it’s tough knowing which method to go for because none of them are pleasant

Massive congratulations 🥳 amazing news!

I’ve told my husband I’m not having sex for the next six months 😂 but joking aside we’ve decided to not actively try to get pregnant for the next couple of months.
My body has been through so much I need a break

@Thorfire I’m sorry there is no heartbeat - but like you said you have a definitive answer now. So bad that the private place measured you so differently!

I really hope I haven’t worried you about the medical route - just thought it’s good to be prepared. But if you have endured 10 days of a natural MC before hopefully this will be ok. The actual full on intense pain didn’t last for too long, so hopefully by this time tomorrow you will be feeling a lot better 💐

I also found the nurses & sonographers in the EPU to be so lovely, it really does make a completely rubbish experience that tiny bit easier

Thanks @Figtree11 im expecting the worst but at least I’ll be at home. If I’m expecting the worst and it’s slightly better than that’s good news.
And I can cope with the pain if I know it won’t be forever x

Im so sorry for your loss.
Ive had 3 miscarriages now, my first 2 i had medical management, that was painful, lots of bleeding for about a day while i passed the baby. My 3rd id already passed the baby before i was due to go back for my second scan with EPAU.
So i passed my 3rd naturally and i found it was so much more painful than the other 2, my second one was a breeze with medical management.

My first i already started bleeding and cramping really bad.
My second i was measuring 5+6 and baby hadnt grown, so i had medical management, again was actually bad, i felt bately any pain. Thought it was my body gettjng used to the pain after the first 7 months prior
My third, i thought i was going to end up in A&E. I was doubled over in so much pain. I sat on the stairs and had to hold on to my doors, my bannister, everything i could hold on to while i was contracting. It was so bad and brought tears to my eyes, it was very painful. Went back to the EPAU and they had confirmed i passed the baby but i had retained tissue so had to have medical management anyway to pass what was left, no pain at all with that, which was nice.
But the pain literally lasted a few hours and that was it. I took the afternoon and the next day off work due to bleeding, but after id passed the baby, the bleeding was absolutely fine.
It only takes a few hours to pass on medical management.

But its entirely your choice on what you do, nobody can really tell you which one to have, we can only tell you our experiences. Good luck x

Hi there I know this is a slightly older post but I am due to get an MVA on Wednesday? Would you be willing to share how long it took you to conceive after your procedure? 🌈 thanks xx

Hi there I know this is a slightly older post but I am due to get an MVA on Wednesday? Would you be willing to share how long it took you to conceive after your procedure? 🌈 thanks xx

I found surgical good

I can't remember exactly but I know it was quickly. After a month or two I think. My following 2 pregnancies were successful

I am so sorry you are going through this. I had a miscarriage and unfortunately had a near haemorrhage. I don’t say this to scare you just be aware what is normal as 111 were utterly useless to me and had I listened to them I’d have likely died.

I ended up in resus and still had retained tissue so had to also have medical management. The medical for me was fine. I wasn’t in pain, I recovered quickly (although emotional scars took time) and it can’t have affected my fertility as I am now 23 weeks pregnant with one who is measuring perfectly.

Thinking of you.

Sorry to see you're going through this, it's awful. I conceived after 3 months of actively trying and I'm now 36 weeks - I hope that gives you reassurance. Good luck for your procedure and be kind to yourself, it's such an emotional rollercoaster.