Medical management - tips and what to expect

[Wiennetta]

I’ve done some research but very grateful for any experiences of the medical management route for miscarriage. I had a scan last week at 6w5d and no fetal pole was found, since then I’ve had spotting and lost pregnancy symptoms. I have a scan tomorrow to confirm the pregnancy hasn’t progressed and discuss options. I’m leaning towards medical management - I don’t want to wait for it to happen naturally and would rather avoid general anaesthetic etc with surgical options.

The EPU said if the scan confirms miscarriage they can give me the medical and recommended I take it in the morning at home, so I’d do this Thursday.

Any advice on what to expect in terms of pain/bleeding/how long it will take? I’ll be almost 8 weeks but the baby stopped developing at around 6 weeks I think.

Thanks in advance and sorry to anyone else that has been through this.

This will not be what you want to hear, but I have had 4 miscarriages, and been through every option, and strongly advise anyone who asks to go down the surgical route.

I personally found medical management the worst option, and found the whole thing quite emotionally traumatic. My recovery took the longest of any of my miscarriages.

I’m very sorry you are going through this.

Hi

I’m sorry for your loss. I took the medical
management for my first miscarriage. I preferred to be in the comfort of my own home rather than in the hospital.

I took the tables at around 2 in the afternoon and the bleeding started around 7 hours later. This meant it was just before I went to bed, which worked out ok for me. I put down towels on the bed in case I leaked (I didn’t) and took paracetamol. I had some cramps but they weren’t too bad, and I had to get up maybe once and hour to change my pad, but I did get some sleep. I passed a few clots, and the next day just had some heavy bleeding, then it reduced the day afterwards.

For me the experience was fine, they had given me codeine at the hospital but I didn’t need to take it. It must be painful for some people though.

I had a positive test after 3 weeks and unfortunately had retained tissue. Although this was the same for my second miscarriage when I chose surgery as well. I chose surgery for the second miscarriage in the hope that it would be over quicker but again that wasn’t the case. The first time though I was afraid of being in the hospital and much more comfortable at home so medical was the best choice for me. I would consider both medical and surgical if I needed to (I did actually take medical for the retained tissue the second time but nothing happened).

Sorry again you have to go through this

Thanks so much @Thesonofaphesantplucker and @Summersun91 for your replies.

Just wanted to come back and update in case it’s useful for anyone else. I took the medication yesterday.

There’s obviously quite a range of experiences as shown above from the replies here. But I didn’t have it too bad. I had moderate/heavy bleeding - heavier than a period but nothing that left me feeling concerned. I had moderate cramps. I only took ibuprofen and paracetamol and didn’t need the prescription painkillers the EPU gave me. I spent the day in bed watching TV and DH brought me snacks and hot water bottles. I did feel a bit nauseous at times so my tip for someone else would be have some plain snacks/fizzy drinks on hand (I had crackers, crisps and lemonade). Have hot water bottles or a heated pad as that really helped my cramps. I did take anti nausea and anti diahorrea tablets - the EPU gave me these and I took them before the Misoprostol. I didn’t feel too sick/wasn’t actually sick and didn’t have an upset stomach.

Overall although the whole experience has been emotionally difficult, yesterday wasn’t physically too bad. I’m still bleeding a bit and anticipate this will continue for a while but today it’s more like a heavy period day. I would use medical management again if I had to as I was glad to be at home and with DH.

Hi @Wiennetta I’m sorry you went through this, I came across this thread as I’m going through a similar experience with my first pregnancy, no fetal pole found, measuring 6+4 weeks and I should be around 8 weeks. I have a scan next week to confirm and discuss options, and leaning towards medical management too as I am terrified of surgery.

Do you mind me asking, from taking the tablets, when did the cramping and heavy bleeding start? And was it just for one day?

@Springcloud26 sorry to hear you are going through this. Hope you’re ok and have support around you.

So I took the tablets on the Thursday, had pain and cramping that day, Friday was fine, then had quite a lot of cramping on Saturday evening. And a lot more bleeding. The Saturday evening was the worst. Sunday was fine, Monday was bit of bleeding but not much pain.

Saturday evening was the worst in terms of pain but manageable at home and other than the Saturday evening and Thursday I was up and about - I wasn’t working but was able to walk my dog, go to the shops and went for a coffee out with DH etc.

I was then at my sisters wedding the following weekend so travelled on the Thursday and by that point was physically very much recovered.

I imagine that it differs from one person to another but I would say plan to have a few days to recover and don’t plan anything.

Overall if I was in the same position again I would use medical management again.

Hope you’re ok and happy to answer any questions.

Thank you for responding @Wiennetta , that’s really helpful to hear your experience. Luckily I am off work this week so have the time to process, I understand why they need to scan again but I feel like it’s just delaying the inevitable. It sounds like medical is the best option for me so I can be at home, if it doesn’t happen naturally beforehand.

Yes I understand @Springcloud26 i felt the same and has already accepted it was going to happen and felt worse waiting that week than afterwards to be honest. Hope you’re ok and glad you’ve got time off to look after yourself. I also should have said that the clinic gave me two sets of tablets, if the first doesn’t induce bleeding they instruct you to take the second. My early pregnancy unit were great and called me a couple of times during the day and the day after to check in - so hopefully yours do the same and you’re guided through it and have someone to talk to if you have any worries at all. Sending you a hug xx

Thank you @Wiennetta I actually started cramping yesterday, but only mild and some red/brown blood when wiping but not filling a pad at the moment. So this could be the start, will see how it progresses and I’ve got my appoint to ask for advice if I need the tablets too. Thank you for all the information, I always feel better with a plan!