Missed miscarriage - medical management, what to expect?

[honeymoon321]

I’m supposed to be 12+3. I went to ED earlier this week with pains but no bleeding, and got a scan on Tuesday which confirmed no fetal heartbeat and gestational age of 8+3. The diagnosis was therefore a missed miscarriage. I was away for work so I came back to my local EPU and had another scan yesterday which confirmed no FH and same GE.

I’ve opted for medical management for a number of reasons. I’m feeling really nervous and scared about the pain and what to expect. I took the mifepristone (oral) yesterday and due to take the misoprostol (vaginal) later today. Has anyone been in a similar situation and able to offer any support/honest testimony of their experience? I am ok to read difficult truths. Also, is this common? Is there anything else I should expect/be prepared for?

I’m really sorry to anyone who has experienced this and thank you in advance 🤍

I am so sorry for what you’re going through and also for what lies ahead.

I had a missed miscarriage in late December 2023 and also opted for medical management. My honest answer is that the literature does not prepare you well for what you may experience - so if you have someone you trust and who can look after you, it would be wise to have them to hand. For me, it was about 6 hours of agony from the time the cramping began, only helped slightly by being in a hot bath. The heating pad and ibuprofen didn’t even touch the sides. At the end, I fell asleep in the water from exhaustion (I think) and came to about 30 minutes later with no recollection of what had happened. My husband was terrified and had been on the verge of calling for help (I don’t actually know why he didn’t - probably just a bit paralysed, if I’m guessing).

Afterwards, I was completely wrung out - it took me a few weeks to feel right in my body again; I’m relatively fit and even going up the stairs caused me to lose my breath. I didn’t tell anyone at work and just carried on as normal - I actually was at work about 5 hours after I woke up in the tub (I work from home). That was a mistake and I shouldn’t have tried to carry everything on my own. It didn’t help me recover physically or emotionally at all.

We haven’t started trying again as I found the whole thing really…painful in so many ways.

If I had to do this again, I would absolutely do some things differently - firstly, I’d try to time it so the hardest part was in the day time (mine was middle of the night - the cramps started about 3 hours after taking the second med). Secondly, I’d try to get stronger painkillers. The double dose of ibuprofen wasn’t enough for me. I’d also make sure I didn’t work the next day or two and I’d be honest with my boss about what I was going through so I’d have been a bit better supported. The things I’m glad I did that made it easier were using a hot bath - I was in there a solid 3-4 hours, and my husband kept changing the water for me and topping it up for me. Also, I really needed him with me - it would have been so much harder to be on my own.

I hope I haven’t scared you but I didn’t want to lie, as the literature I had really didn’t prepare me at all for what I went through and I think it made it harder than it had to be. I also hope my learnings can help you a little 💙 Sending all gentle hugs and strength to you.

@toomanycatsonthedancefloor thank you, it is really hard when I don’t know anyone who has been through the same. Could I ask how far along yours was? I appreciate the timing of your comment so much. It is so hot at the moment and I’m thinking if I wait until tomorrow daytime the effects of that may not help. I’ve been advised to insert today at 5pm. This is scary but I have been given opiates but I am just dreading this experience. Thank you so much for your comment and I am sorry you went through this too

I was 9w at the time of the miscarriage but the fetus measured at 6-7w.

I was just thinking of you in this heat as I went outside. Trying to remember timelines, I think it was around 6-7pm when I inserted, and I had minor cramping from about 9; I didn’t think it would get worse than that based on the lit so I went to bed to try to rest, and woke up around 10:30ish in real pain. Everything was done by around 4-4:30 the next morning.

You have stronger drugs than I had so maybe it will not be the same experience - I really hope it goes easier for you than it did for me 💙

I'm sorry for your loss OP x

I had medical management for TFMR at 12 weeks. This was abroad, so I was in hospital overnight. I'm assuming you have be sent home OP to do this? I've since also worked in the UK on a ward where patients had this procedure, so have seen it from both sides. We kept them onsite for monitoring though.

These are just my tips. Do a wee before the vaginal tablets are put in and wear a maternity pad and comfy, old PJ's or nightie. If you can, lie down for an hour or so. If you start getting cramps, see if you can walk around and move about. This helps open the cervix.

The meds can cause diarrhoea, nausea, vomiting and a high fever- not for everyone, but common. My face looked like a beetroot and I was burning up. Its not an allergic reaction, just a side effect which passed once I had paracetamol. Its common to see a tablet fall out, or part, or to see a white paste when wiping after the loo. Don't worry, they will still work.

This was my 1st pregnancy, and although I did find it painful, it was like very bad cramps. I wished I'd asked for something stronger than paracetamol, but I found the burning up face and diarrhoea so distracting that the pain wasn't as bad. After the paracetamol, I did feel calmer and lied down to rest.

Sorry if TMI, but I then felt a 'pop' and water ran down my legs. I'd wrongly assumed I'd only have waters later in pregnancy. The pain immediately went and I passed the pregnancy. From time to inserting the meds to passing products was several hours from memory.

Everyone copes with pain differently. Gestation, previous vaginal births, pain threshold etc all have a baring. I've seen woman at earlier gestations needing much stronger analgesia, then others need none at all.

Do you have anyone to support and be with you? If you have any questions, feel free to ask. ❤️

@JDM625 yes I’m managing from home as I had oral meds at my hospital and I am relieved as that indicates they don’t feel I’d need obs. This is so helpful that you have professional experience in addition to your own - thank you very much for sharing. This is relieving to hear and not TMI at all, I’m sorry you had to go through this too. I have my partner at home with me but I am worried about scaring him. I am also not sure about what level of blood after passing the pregnancy is normal - my periods are normally quite light so I guess it will be more than I am used to and have prepared myself for this. Thank you so much again. you have offered amazing advice in a time of great need 🤍

@toomanycatsonthedancefloor thank you so much - this is helpful for timeframes etc and really appreciated. You are so kind, wishing you well 🤍

I had two. A long time ago now. I’m so sorry you’re going through this - all the best. For me, the medical management for first was painful and very difficult emotionally. The second was after I had had our eldest child. It was sad but very little pain and nowhere near as emotionally difficult.

@BicesterCoffeeDays thank you I do appreciate you sharing - I’m sorry you had to go through this too

How are you doing OP? Did you insert the pills at 5pm?

@JDM625 thank you that is really kind of you to check. Inserted about 6.30pm (I was really hungry and needed to eat some dinner to help with avoiding symptoms) I am doing ok, the painkillers are definitely doing their job as I have already had one round and got up from bed to change around time to take again and the pain was definitely worse. Feeling a bit spaced out from the pills but hopefully the next few hours will have this over. Thank you again so much

Just came across this thread. Hope youre doing ok

How are you doing OP? I hope you got some sleep lastnight xxx

Hope you're OK op