Found out I had been pregnant with another baby 5 weeks after birth

[HungryTrucker]

I am going to try to be brief here because I feel like my whole journey to having a baby could be some obscure plotline from a TV medical programme.

After several years and 3 rounds of IVF, I gave birth to my beautiful daughter in May via emergency c section as I wasn't progressing and showing some signs of infection. Despite the situation, the section felt fairly standard and I was told it had gone smoothly.

I was discharged from the hospital 2 nights later, however 4 days postpartum I experienced a very large bleed at home and was sent back to hospital in an ambulance. At the hospital, they inspected me using a speculum and managed to retrieve lots of very large clots and retained membranes.

I could go into some detail here about the endless back and forth on further testing (or lack of) and I do feel quite overlooked throughout this whole experience. However, in short, I was discharged 2 days later with some antibiotics and no reassurance this wouldn't happen again. A few days later, I passed a clot the size of both my palms and returned to hospital, where I was referred for an 'urgent scan' that then didn't take place for over a week.

The scan continued to show retained membranes and potentially placenta, however this wasn't communicated to me until I experienced severe cramping a few weeks later (worse than my labour pains) and ended up back in hospital again. The next day I had another scan and was referred to gynae the same day for a D&C.

Prior to the D&C, the doctor decided to do one more speculum inspection, where he found I was dilated and managed to retrieve a surprisingly large mass. This is despite the scan suggesting the retained products were only 3x4cm.

The doctor said the mass didn't look like retained membranes or placenta and that he believes it is a calcified fetus of around 10 weeks, which he suspects is the twin of the baby I delivered 5 weeks before. I am left absolutely baffled/devastated by this, as we had multiple early scans with no suggestion of twins.

They are going to send what they found for histology testing, which will take 2 weeks to come back. I am now left wondering how this is possible or if the doctor might be wrong and I will spend 2 weeks mourning a twin that never actually existed. There's also part of me wondering if this is definitely from this pregnancy or if it could be older than that and perhaps the reason why we struggled to conceive for so long? (Although I've had MANY ultrasounds so would surely have been spotted).

If anyone reading has also had a histology test, I'd be interested to know what it tells you? I know this situation isn't very conventional, but I am really desperate to find out when this baby was conceived and if it is a twin of my daughter.

Goodness- no advice but I am so sorry you've been through this. Hugs to you.

No direct experience - that sounds really awful but the only thing you know for sure right now is you have a beautiful little girl so I'd do my utmost to focus on her for the new couple of weeks and not jump to conclusions.

Yes, she's a proper gem. I think that's why I will feel quite annoyed at the doctor if it does turn out to be something completely different as it's a huge bombshell to drop without being certain and hard not to look at her and think 'wow, imagine if there were two!' I already feel like this experience has robbed a lot of the joy of the newborn period so don't want another 2 weeks of pointless distraction.

Oh wow that’s quite an experience for you and all the bleeding and hospital trips must have been so scary and tough.
I would also question how is it possible that nothing was picked up on early scans, as being IVF you must have had close monitoring. I would try to keep an open mind for now and not take what he said as the final word until the results come back… do chase them up for the results though as if it’s nothing abnormal it may not flag up and they may not report back to you, so keep asking them for the results.
And congratulations for your beautiful daughter!

OP - maybe it is worth processing this with PALS?

This seems a bit premature. What would you be seeking from PALS at this point? Seems like it would just be more stress for OP.

So far it seems OP has had some retained products, which is horrid for her to deal with, but ultimately a recognised complication/risk. It seems, without having more info, that this has been appropriately managed with antibiotics and allowing time for the body to reabsorb or expel the products, and when this hasn’t happened OP has, appropriately, had a procedure to help. The attending doctor has found something unexpected/unusual and has shared his differential diagnoses with the patient so she is fully informed.

IF the histology returns as a calcified foetus then that would definitely be something to take to PALS, because if it was as large as suggested I would want to know how the operating doctor missed it during the c-section.

I think it would be surprising if it were to turn out to be calcified foetus because that means it has been missed by multiple clinicians, at multiple USS and c-section. And that seems unlikely (though admittedly not impossible) and would warrant some further investigation into how it was missed.

I’m also not sure the duration of a pregnancy is long enough for flesh to calcify? It’s usually a very long process. But I have no expert knowledge on this.

Ultimately, OP, I’m sorry you’re having to navigate this during the already difficult post-partum phase and hope you have some real life support. Make a list of any questions you have so that you can make sure you fully understand what has happened. A good doctor will be happy to explain things carefully and as fully as you need to be able to process events.

Thanks all. I agree PALS could be beneficial down the line but not right now. Partly as I want to try and just focus on my baby, as I do feel like I've missed a lot, but also need more info.

Regardless of outcome, I do think my hospital lacked adequate process on how to care for someone with retained products. For example, I was never told I was higher risk for it after my section because my membranes had been ragged and what to look out for. I was also continually told to 'monitor it' but then every time I had something else happen that shouldn't have, the first response would always be to 'keep monitoring it to see if it happens again' rather than taking any action. I feel this really neglected to consider the mental health impact of what I'd been through and how scared I was/am of hemorrhaging at home again. I also had to really push for the scans I had, the results of the first one were misreported to me and it was never explicitly stated that the hope was that the products might come out on their own or reabsorb. So, some things they can learn from, although I could never feel angry with the people who treated me as I do think it was clear they were doing what they could in an incredibly busy and difficult environment.

How did it all go, do you have the results? Sorry for your complicated story xx

How did it go OP?

@Clangershome @pizzaandchips123 Still no results yet unfortunately! I called to chase the other day and they told me they could take 6 weeks another 2 potentially to wait.

keep is updated and in the meantime enjoy your little one

I had my 'results' - if you could call them that! I phoned the hospital again at 8am today to say it had been 6 weeks and had heard nothing. Finally received a call back from the doctor at 9pm. The doctor asked why I wanted a call and I said I hadn't had any results and she said they don't normally tell patients them unless further action is needed. This is even though it said on my discharge letter that someone would write to me with the outcome of the test. Apparently if 'they called all their patients with results then they'd just be on calls all day', which is fair enough but I was told I'd get a letter.

She then said that the test had confirmed 'products of conception' which feels like a completely pointless result because of course it is some type of product from pregnancy! Products of conception can mean membranes, placenta or fetal tissue so when I asked what this meant precisely, the doctor just said 'well, you've had a miscarriage right?' When I said no, that I'd given birth, she just said it'd be something left over from that. I tried to explain the miscarried twin situation and what the other doctor had said and she just laughed at me!

I feel this has told me nothing. I was starting to feel okay about everything but I am quite upset about how the doctor spoke to me as she made me feel really stupid or like I was lying about what the other doctor had said. She also clearly hadn't read my notes at all. I feel like if you work in the miscarriage department then maybe be a bit more sensitive in how you speak to patients. I feel pretty shit now and might put in a complaint but going to see how I feel after my birth reflection next week. I'm not even that upset about not really knowing, but feel sad that something so traumatic has ended with someone laughing at me and not listening at all.

So sorry OP. Please put a complaint in about this doctor.

Sorry you’re going through all this OP.
agree with PP the idea of a twin seems far fetched honestly - you wouldn’t think a 10 week size fetus could possibly be missed on scans throughout the pregnancy as well as at your CS. It seems much more likely that it has been retained placental tissue.
it sounds like the hospital has handled things really badly for you and I agree with others about perhaps seeking feedback/debrief process (I am not in the UK but I think this is what PALS would support you with)?
all the best with your new baby and I hope this hasn’t taken the shine off things too much.

I’m so sorry to hear you’ve been through all that. How incredibly stressful, especially with having a newborn.

I had an emcs with my firstborn. Also ended up with an infection and retained placenta that took months to resolve. I remember the anger that it was missed and the stress it put me through that robbed the happy weeks. I kept asking myself how it was missed during a c section.

im currently pregnant, and at around 8-10 weeks I had two huge bleeds (we thought we had lost baby there was so much blood). I’d had around 6 early scans by this point (2 were private) due to spotting and then the huge bleeds. At my 12 week scan, I was told it had been twins as the other sac was clearly still present - this was a huge shock, given how many scans I’d had. Was told that the sac may bleed away or remain there until the birth. I’m now 27wks and they think it’s gone. I still feel sad the other didn’t make it, but so grateful my surviving twin is strong.

I just wanted to validate you that the previous doc MAY have been correct about a twin, but similarly it could have been retained placenta in this case. It doesn’t excuse how you were treated and spoken to though. I’d deffo speak to PALS about this when you feel strong enough. Also, please ask your midwife/health visitor to book you an appointment with your hospitals birth debrief/counsellor midwife. They will be a sympathetic ear and talk you through everything that happened and give you a safe space to speak about your feelings. It can really help process it all.

big hugs to you.

I am sorry you are going through this, it does sound traumatic.

Wait and see what the results show.

A fetiform teratoma is a possibility but there isn't much point in speculating.

Have you read OP's latest post?

@TenThousandSpoons00 Thank you! Yes I agree it's a bit far fetched, which I think is probably why the doctor just laughed when I tried to explain it. I have a debrief with the midwife at my local hospital soon, who I saw during my pregnancy and were always brilliant so I am hoping that will bring a more positive sense of closure.

@CustardCream31 I am really sorry to hear about your experience too. It sounds like we had a similar number of early scans as I also had bleeding, although this was diagnosed as a subchorionic hematoma. I had HCG testing too and I remember when the result came back that nurse at the fertility clinic checking they'd only put one embryo in as my result was higher than expected. So, while probably unlikely, interesting that the twin may have been a possibility. I do actually find not knowing strangely comforting.
Wishing you all the best for the rest of your pregnancy and I hope you find your birth/newborn experience healing after last time.

I've had my results back and confirmed as some type of product of conception so fortunately not this. Interesting to read about though as the doctor told me the result wasn't 'unusual' and I had wondered what 'unusual' would actually entail as I thought it could only really be products. Must have meant something like this!

That's excellent news, I thought it was likely to be retained products of conception but you never know. Either way you know you did not lose a child and that must be a relief, I'm so pleased for you. Not a pleasant experience but now it's behind you. Congratulations on your lovely baby!