Missed miscarriage NHS management

[ThisZippyViewer]

Hi everyone I was hoping if anyone who had experienced a MMC wouldn’t mind sharing their experience

MMC found at a private scan earlier this week
Attended EPU yesterday and confirmed
They have asked me to attend again in 7 days time for another scan before treatment options are discussed - we asked to speak to a doctor but they wouldn’t talk to us.

The nurse said they are unable to use the private scan as a scan but 7 day wait to go through it all for a 3rd time just seems so cruel. Was anyone else made to wait this long?

Baby stopped growing 5 weeks ago which I am finding so hard to understand so I just want treatment options explained and starting asap

I have just experienced a mmc. My experience is totally different to yours, I found out on Wednesday, I was 13 weeks but baby had stopped growing at 11 weeks. 2 sonographers confirmed no heartbeat. I was due to have medical management next Wednesday, but was able to get it moved to yesterday so it wouldn’t be on my dd’s birthday.
I’m so sorry you’re being left in limbo for so long, I would recommend calling back and pushing for earlier treatment

@TheFutureIs thanks so much for your reply and so sorry you are going through this as well it is awful

yes we had two sonographers in the room yesterday - something about the wait just doesn’t seem right to us and everyone around us. Probably won’t get anywhere with it being the weekend now but will keep trying

how have you found the medical management? Xxx

I suspect they just want to be very sure that it isn’t a viable pregnancy with very inaccurate dates (eg that you are only five weeks when you thought you were much more, and that next week there might possibly be a heart beat).
It is a brutal wait. That tiny whisper of hope when really you know there is none.
Best wishes with all of it.

Sorry you’re going through this.
With early mmc they need to make you wait a week between 2 official scans to make absolutely sure there’s no viability of the pregnancy. If the length of the fetus is under a certain amount then it’s deemed too unreliable to go by one measurement on one day.
Did you bring the private scan report with you?

@Awobabobob thank you so much for this explanation - tbh all we wanted yesterday was someone to sit down with us and explain the reason behind it but they wouldn’t speak with us. I know nhs services are stretched but the whole experience was awful. Yes i took the report and they looked at it but said they couldn’t use it as private service which I understand but just the 7 day wait seems extreme 😔

@Bobbie12345678 brutal is the word for it! We had an EPU scan at 6w (5 weeks ago) which showed a heartbeat so I thought that could have been considered alongside yesterdays but must not be allowed

They told my daughter that she had to wait a week for a scan before intervention because a majority of the time once no heartbeat detected you’ll most likely naturally pass it, which they say would be like a heavy period!
Unfortunately my daughter didn’t so was given the abortion pills!!

It’s seems cruel but unfortunately it’s absolutely necessary. It’s happened in the past where viable pregnancies have been mistakenly terminated due to inaccurate measurements by the sonographer, so it’s to guard against that.
Best of luck with everything

@Awobabobob thank you 😘😘

I'm so sorry you're going through this, it's awful. I also had a MMC and surgical management a week ago. I had a very similar experience to you, I had a scan at 6 weeks with the NHS and everything was fine there was a heartbeat. Then felt anxious at 9 weeks and decided to go for a private scan for reassurance...and found out baby had stopped growing at basically 6 weeks and a few days so must have been just after the first scan 😞

I had to then go and get another NHS scan because they told me the same, that they can't accept private scan notes and need to verify. I'm surprised they're making you come back for a third time though? That just feels cruel. I was able to discuss management options on the day I went for the NHS scan to confirm. I opted for surgical management and because of having an abnormal uterus shape it needed to be general anaesthetic rather than local which meant waiting slightly longer (a week) to get booked in. They were prepared to give me medical management medication on the day if I had opted for that, or local anaesthetic surgery a few days later.

There was another scan on the day of the surgery to check again. I do understand what others are saying that they want to be absolutely certain about things. But it's such an awful thing to go through and I'm so sorry you're having this experience. I'm still bleeding lightly but physically the recovery has been very simple. I'm happy to answer any questions about the process if that's helpful.

I'm so sorry this has happened to you. I had three MMCs and experienced the same as you. We had heartbeats confirmed at private scans around 6 weeks and then sadly lost the babies at later scans with NHS (ranging between 8 - 12 weeks). As pp have said, it's true that the NHS cannot take the private scans as evidence and because you're around 5 weeks they do need to wait 7 days to see if there is any development to ensure a viable pregnancy isn't terminated.
I totally understand how you're feeling, it is heartbreaking having to go through it again.

In terms of treatment options, I was given 3 options each time: wait for it to pass naturally, medical management or surgical management. I opted for surgical every time but on the 2nd time they booked me in for 2.5 weeks later and unfortunately I ended up miscarrying at home which I found really traumatic. I personally would always opt for surgical because of this.

Am so sorry OP, be kind to yourself x

@am316 @FlipperyGibbet 😘😘 so sorry you’ve both been through this - a horrible club to be a part of

I am back and forth on management, probably made more difficult by the fact no one medical has had a discussion with us yet! My initial thought was surgery as heard medication can be traumatic but then reading things on ashermans syndrome has frightened me. I should be 12w today and baby stopped growing at 6w5d and still nothing moving which is just madness to me especially as symptoms have continued and my body has been changing 😔 I’ve read the further you are away from the miscarriage the higher your risk is for ashermans which is would make mine very high - but don’t want to go through the medication just to have to get the surgery anyway as I’ve heard this can happen. Really struggling to decide.

I called the Tommy's helpline which was actually really helpful and comforting. I was already quite confident about wanting surgical management, because we had had a TFMR years before that needed medical management and I didn't want to be reminded of that trauma. Tommy's could definitely help explain the options to you, the woman I spoke to was brilliant and signposted to other support as well that I probably wouldn't haven't found just googling myself. Sorry this doesn't help you at the weekend though! I believe they're only open Mon-Fri 9-5.

In terms of scarring and ashermans the doctor who did my surgery said it's more of a risk after repeated surgeries, but even then low risk. I also think it's maybe worse for a D&C procedure but not as bad for MVA which is what you would have when it's this early. But don't quote me on that I think I've just picked that up from reading around and not a doctor!

Focus on all the self-care this weekend and be kind to yourself ❤️ easier said than done I know when you're impatient to have a plan and still trying to process all the emotions. I think the worst for me was having all the pregnancy symptoms and nausea still which felt like such a slap in the face knowing it was all for nothing now. Maybe a glass of wine/hot bath?

As I was over 10 weeks my only real option was D&C (now called surgical management of miscarriage).
I had a general anaesthetic and was under for less than an hour.
I feel ok today, but of pain in my throat from intubation, and bleeding a bit. Personally I would have opted for surgery anyway as I liked that it would be on a set timeline, and is more predictable for outcome

As you mentioned the bit Ive really struggled with is how my body continued with symptoms of pregnancy, and even carried on growing a bump. It’s just so cruel

@am316 😘😘 thank you this is so helpful, I will give Tommy’s a call on Monday and make sure I get some clarity on risks at the appointment next week from the doctor. A few wines have been knocked back so far this week 😅

@TheFutureIs yes the completeness of the surgery is why it was my first thought! 😘 wishing you a quick physical recovery and sending lots of love.

Just as a heads up if you choose surgery, they do ask some questions about what you'd like to happen to the baby afterwards. No one warned me this would be asked and it totally floored me. I was more prepared the next time, but I still find it one of the saddest parts of what is an entirely upsetting process to go through!

We had a similar wait - we had a private scan at six weeks where they could only see sacks, so told us to wait 2 weeks and then go to the EPU. They then made us wait another 7 days after their first scan, so three weeks in total before missed miscarriage was confirmed. During the final 7 days I actually phoned and begged them to let me come back sooner because there was clearly no hope and I just wanted it dealt with. A very patient and lovely nurse explained the guidelines and why they had to wait. (The only time I saw a doctor was when she came to do the consent form for the procedure and then the procedure itself - the unit is nurse led and they were all lovely to me and my partner.)

I had an MVA earlier this week, because I didn’t want general anaesthetic and didn’t want the uncertainty of waiting to see how it went at home (having done that for three weeks already). The procedure was absolutely fine and I went back to work after having a day off. I did hope that it would give closure but I’ve had some unexpectedly painful cramping in the afternoons/evenings. I phoned yesterday to check this was normal and apparently it is. It’s bloody annoying though.

My body continued to behave as though it was pregnant all through the waiting period as well, but within 24 hours of the MVA all symptoms had gone.

Oh @Fallulah should you be back at work so soon? I’ve been given time and space to grieve by my school.
No way I’d be ready to be back in the classroom

I’m also a teacher and we had INSET Weds - Fri and to be honest I needed to be back; I was just stewing at home. I’ve told some colleagues and they’ve been lovely. I could have had time off if I’d wanted it. I’m actually ok with the actual miscarriage bit, having had the three weeks of waiting to somewhat come to terms with the idea. I’m just absolutely sick of the pain every afternoon/evening as a reminder of what’s happened!

Hi op, I'm so sorry you ate going through this. They really are just following their policy though, which exists for your protection. They have to be 100% sure they don't accidentally terminate a viable pregnancy. I'm sorry xx

@FlipperyGibbet 😘 thank you for this. Things seem to have potentially started naturally today so not sure if will even make it to later in the week to get the options. Sorry to ask and don’t answer if you don’t feel up to it but what are the options for baby after surgery?

@Fallulah sending lots of love xxx how did you find the local anaesthetic if you’re willing to share? Xx

@NewLifter thank you so much 😘 realised from all the online reading it is protocol just would have made things easier if someone explained it to us that way at the appointment so we could process it instead of just being handed a follow up appointment card and nothing else 😔

@ThisZippyViewer Honestly it was fine. The most uncomfortable part was when she put the speculum in at the very start - it hurt and I asked her to stop, and explained that I have the same problem with smear tests, so she change it for a smaller one which was much better. I think I felt the first injection of local go in, but it really wasn’t bad - no worse than when you have it at the dentist. They warned me I would feel hot for a few seconds and I did. There was gas and air available and the lovely nurse was telling me to use it but I couldn’t feel anything.

We were given the option of taking the ‘contents’ home or the hospital has a contract with an undertakers who collect them (along with any others) and cremates them and sprinkles them in their memorial garden. It’s not individual but we felt that was the best thing, particularly as ours never really had the chance to develop into anything. We might have felt differently had it been a later loss.

That’s interesting, we were told all the remains would be sent for cremation after samples had been taken. My dd wanted to bury the baby but we’d told her it wouldn’t be possible

Oh yes you are right - they did say it would go to histology(?) first but that they would only contact us if something unusual was found.

We had the option of cremation and scattering the ashes in the baby memorial garden at the hospital (acknowledging that given the early stage of gestation, there wouldn't be a large amount of ashes) or 'disposal' in line with human remains. The second miscarriage was meant to be collected and tested for genetic abnormalities but wasn't possible due to miscarrying at home. The third baby was sent to the labs for genetic testing following the surgery