Recurrent miscarriage guidelines

[funtimewincies]

Please forgive me if you've seen this stuff from the Royal College of Obstetricians and Gynaecologists before.

I'm beginning investigations into why I've had recurrent miscarriages and I came across this document which is the only time I've seen the information set out clearly about what the causes might be and what tests might be done.

I was also VERY interested to see that the guidelines advise that if you've a miscarriage history, being seen at EPAU during early pregnancy before you miscarry might improve your chances of maintaining a pregnancy. I've had to fight tooth and nail to be seen when I am miscarrying, let alone when all has seemed OK.

I've printed out a copy for future ammunition if I'm in the same situation again .

Thanks for that funtime.. I've had two back to back mc's now, so I can't quite say I've had recurrent miscarriages, but it's useful to know. Hopefully I won't be in that situation.

I'm not quite sure what they mean about attending an EPU in early pregnancy helping prevent miscarriage. I've miscarried at 5+5 and 6 weeks, so even if I'd been scanned they wouldn't really have seen much. Our local EPU is brilliant, but I'm not sure how going there as soon as I get a bfp will help. The midwife I spoke to last time said to me that the outcome of the vast majority of pregnancies is decided at the point of conception so if I'm going to miscarry nothing can prevent it.

Thanks for posting that very useful information, much appreciated. I too have printed it out incase i need it again.

Headfairy - there is also information for clinicians on the same site and it talks a little more about the benefits. Apparently there is some evidence that women who've had several miscarriages where there is no apparent reason, are more likley to carry successfully when they've had access to EPAU from early on. Although the mechanism isn't understood, it's thought that there may be psychological benefits which somehow just give them the edge. Maybe it reduces stress levels and therefore the stress chemicals sloshing around the bloodstream, who knows?

I was really just reflecting on my own experiences. Even after 2 miscarriages and an ectopic my midwife can't order an early scan, apparently 'it's up to the sonographer' who is in no way involved in my care or the management of my pregnancy. The only roundabout way is to be referred to EPAU with either a suspected miscarriage or with made-up symptoms (which I've never done, but been tempted).

All very stressful .

It's amazing how care varies across the country. Our EPU works a walk in system, you have to be there by 8.30 but last time I only had to wait 20 mins to be scanned (a bit longer for bloods) and they are happy to scan you even if you haven't had any signs of impending miscarriage. Anxiety is considered a perfectly adequate reason for a scan. Just knowing that it's there is very reassuring, hasn't stopped me miscarrying yet, but maybe in the future...

Poor you

when you say site, do you mean the miscarriage association?

No, I found it through this site.

Blimey, a walk-in EPAU! Very enlightened and obviously the sort of thing they're talking about. In my neck of the woods it's much more of a 'there's no sign that anything is wrong, stop being so neurotic' attitude. But that's the problem, there wasn't any sign that anything was wrong but it was going wrong all the same .

As you say, it's the reassurance that's so important, knowing that you could access it if needed.

I've just read my other messages back and it sounds like I'm pg at the moment, I'm not . I was referring to my last pg, which ended in a 3rd mc.

I'm on the 2ww and, as ever, trying to stay positive .

Oh thanks for that, I'll have a read later. Gotta dash off in a mo. I'm so sorry to hear your EPU isn't as accessible as ours. I'm sure ours is so great because it's a huge teaching hospital (St George's, Tooting, S London) and they have the neo-natal high care unit for the whole of the south east, so their ante-natal/maternity/post-natal services are second to none. When Prince Edwards wife had her dd early, she (Sophie Wessex) was in the private Edward VII hospital all the royals are taken to, but her dd was taken to St George's as the unit there is amazing. We are very lucky indeed.

Ahh, it's out in the sticks for me I'm afraid! Take care.

Have decided to put off trip to the supermarket til after lunch, I spend too much if I'm hungry

It is rotten that services vary so much across the country. What's your nearest city? Is it too far to self refer yourself?

I'm in rural-ish Wales, so services have to provide for a large geographical area. Maybe they're afraid that the EPAU unit will be misused, or that they'll be over-run for scans. The unit comprises one lovely lady, doing her best.

Know what you mean about the dangers of food shopping when hungry!

funtimes thats a really useful post. Its nice to see that the potential causes of a miscarriage are acknowledged as I think women all too often hear "oh it wasn't meant to be" or "you have just been unlucky".

I second what you were told about early scans. I have had 3 mc in the last years and was referred after the third to a wonderful consultant in recurrent miscarriage at one of our local hospitals. By the time the appointment came around (and I didn't have to wait too long for it to come through) I was 6 weeks pg again. She scanned me every week until my 12 week scan and said that research does show that this sort of care CAN help in maintaining a pg. It takes a lot of stress and worry away for women who have suffered recurrent mc. Well, the proof is in the pudding and I am still pg. Am now 28 weeks. Its not the only time I've heard this. My SIL is a midwife at UCH in London and says that the consultants there say very much the same thing.

Funtimes... that's a shame. Our unit is pretty stretched I must admit. There's one sonographer working, so it can be a bit like a production line, but I'd rather that than no scan.

Great to hear your success story ladyhelen, gives us all hope

Congratulations ladyhelen, lovely to hear a positive outsome !