Confused - Blighted Ovum / MMC

[LosingtheTTCplot]

I should be 10 weeks today and had a private scan on Saturday but the sac was empty, she suspected a blighted Ovum. I’m 100% on my dates so was referred to EPU.

I had an NHS scan today and they said the same pretty much but they will not diagnose it as a blighted Ovum as my sac is not the correct size to be classed as a blighted Ovum and there are irregularities with/in the sac.

I have to wait 10 days for another scan but she said it will be one of three things.

• I’ll miscarry in the next 10 days (could be sac irregularities are the sac breaking down)
• No change
• Something may develop, but unlikely.

I think she was trying to politely say, go home and wait for the miscarriage. If the miscarriage doesn’t come in 10 days then they will discuss things.

Been a bit crampy this afternoon as had abdo and TV scan.

I just want it over and done with now and was really snappy when she wanted me to wait 10 more days, as if 10 weeks wasn’t long enough for my body to be fooling me for.

I’m confused as if it’s not a blighted Ovum, what is it? A MMC?

I’m sorry you are going through this. It sounds to me like a blighted ovum (which is a type of missed miscarriage) It’s happened to me twice. Both were around the 10 week point.
The reason they ask you to come back in 10 days is because the sac has to be at a certain size before they can 100% confirm that it is a blighted ovum (mostly just to cover their own backs in case they are wrong). The first time it happened to me I was about 1mm off them allowing to call it a miscarriage. The wait to come back and have it made official was one of the worst times of my life. I totally get the frustration and feeling of just wanting it to be over. I found the information and support from The Miscarriage Association really helpful during this time x

So sorry you’re going through this - sounds really similar to my experience last year. No-one ever used the phrase ‘blighted ovum’ at the hospital but I looked it up afterwards and ‘self-diagnosed’. I was also 10 weeks and certain on my dates, I had an empty yolk sac on a scan - ended up on the EPU due to some very light brown bleeding. Was sent away and told to come back in two weeks, which was the hospital policy to see if there was any change before any action was taken; even though I was sure on my dates, they said there was a chance a fetal pole could develop if my dates were wrong and I was earlier than thought. I knew there was no way this would happen as I’d need to be out with my dates by about 4 weeks. About a week later I miscarried the pregnancy at home and then went for the follow up scan which showed it was gone. Totally get what you mean about not wanting to wait, I was also very frustrated about having to wait for confirmation. Thinking of you

This happened to me with my first pregnancy too. I thought I was 8 weeks but just felt something was wrong. I went for a private scan and they found only a sac. They said it could be I was wrong on my dates or my pregnancy wasn’t viable. They sent me to EPU who said the same. They also rebooked me for two weeks time.

It was a horrible wait and I cried everyday. Probably the most stressful thing I’ve ever been through. I had a tiny hope that maybe dates were wrong, but the day before the follow up scan I started to bleed. The scan didn’t really show any change, so they could then diagnose miscarriage. I decided to have surgical management as couldn’t face waiting any longer for it to pass.

I’m really sorry you are going through this at the moment. The wait is really horrible, but the sonographer told me that she does see ladies getting their dates wrong all the time so they don’t want to be end a pregnancy until they are absolutely sure.

Hi really sorry to hear your news. I hope you don’t mind me asking- do you know what the measurements of the gestation sac were?

From your description It sounds like and Anembryonic pregnancy. Blighted Ovum is not terminology we use anymore. With this kind of pregnancy the hormones continue in the body for a long time hence why nothing has happened yet.

I wish you all the best x

I’m hoping the irregularities in the sac mean it’s starting to collapse and break down.

I truly think that’s what she was suggesting when she said to wait 9-10 days as she probably knows it should hopefully pass on it’s own.

I just feel so angry at, well everything, as it took a year and 4 early miscarriages to get to this point and feels as though the last 10 weeks have been for no benefit.

Is there anything I can do to move it along and start the miscarriage?

@ShinyBadger I don’t know about today’s measurements but attached is my measurements from private scan on Saturday.

Hi OP

I'm so sorry to hear you are going through this!

So, last July at approx 5 weeks pregnant I had some spotting. I went to the emergency gyne unit and had a scan. Exactly the same thing, saw the gestational sack but couldn’t see anything in it. They did 48 hour HCG tests and unfortunately they only went up 10% meaning that sadly it was not a viable pregnancy. I was scanned over a couple of weeks (I think it was about 2) with repeat HCG tests every 48 hours (fucking emotional torture) and despite my levels going up 10-12% and my gestational sack getting slightly bigger each time sadly I was diagnosed with an anembrionic pregnancy (or a blighted ovum).

Anembrionic was the clinical diagnosis I was given but I think it is more colloquially known as blighted ovum!

So, a blighted ovum not unlike a "typical" miscarriage is a predominantly always due to a chromosomal disorder! So at conception - sperm meeting egg/implant - there is something really chromosomally wrong with the embryo so your body absorbs it!

Don't let anyone tell you you weren't pregnant, you absolutely were! Your body just detected that something would have been so wrong with the embryo that it wasn't viable!

Unfortunately there is no definitive timeframe for a blighted ovum to pass and there is nothing they can be done in terms of speeding it up!

In terms of management you can either:

• wait for it to pass naturally - days or weeks
• medical management - take a pill and it will pass - hours or days
• surgical management - immediate

I opted for the surgical management!

I hope this helps but please do feel free to ask anything further questions xx

@LosingtheTTCplot, I’m sorry your going through this. They won’t confirm it as an anembryonic pregnancy because the mean sac diameter was 19.5 mm - following National guidelines we are not allowed to call it a miscarriage until the empty sac reaches a MSD of 25 mm. I hate it when I meet ladies in your situation and the sac is not quiet big enough to be able to call it. We used to say if a patient has had a private scan and the report Was available we are the “rescan” and there has been no growth, Irregular (so starting to break down) or hovering around 20/21mm we would then say and offer treatment options. We leave it two weeks normally so that it gives time for there to be change ie reach the msd of 25mm or stay the same. Each hospital is different though.

It’s so hard certainly if it’s been a long road to get there. Don’t be angry and it’s certainly nothing you have done wrong. It’s just one of life’s sh*t things it throws at the good people.
If the sac is irregular it’s is starting to break down, but sadly the hormones levels remain high in the body. Hence why you may not start to bleed yet. Least when you go back they can offer you all the options, if nothing has changed. I wish you all the best - don’t be hard on yourself, be kind.

@ShinyBadger thank you, your info is super informative.

I’ve had really bad and sharp cramps this afternoon and what feels like Braxton hicks, no bleeding yet but in a way hoping it’s the start.

Xx

Hey OP in this same position right now. Literally been following every thread that is similar

I feel for you. The wait is absolutely terrible. I have to wait till 20th for my rescan. Until then the brown spotting continues. I don't even have cramps and continue having pregnancy symptoms like nausea and sickness and sore boobs... I feel like I'm going to go to the scan and just find out my body has been tricking me into feeling pregnant when I've lost the baby sadly...

I'm sorry. Here if you need to talk. This waiting game is the worst

@Furbsies my scan is on the 20th too.

I woke up with little cramps this morning and an hour in and walking about the tightenings have started again.

Feel like my body is playing awful tricks on me. I don’t actually feel pregnant anymore, no nausea, boobs less painful and less swollen. Hoping my HCG is dropping and I’ll start bleeding soon. Xx

@losingthettcplot I'm so sorry. I had slightly more bleeding last night and thought it was starting do got ready for it and then went to bed, woke up this morning with absolutely nothing again and finding blood only when wiping.

None of my symptoms are gone either. I just feel way worse than I did before.

Just hang in there, I'm trying too. Hopefully, we are through the worst of it soon..

@Furbsies @LosingtheTTCplot

When I had my anembrionic pregnancy the most excruciating thing was the fact that my pregnancy symptoms were continuing/even getting worse!

That's because your body still thinks it's pregnancy and why my (and I will assume yours) HCGs and sac will be growing - albeit not enough :(

I remember the waiting and the rescanning and the repeat bloods and tests! It's was heartbreaking and made all the more confusing because my "odds" of viability changed from person to person and one doctor even congratulated me on my pregnancy! It basically got to the point where I totally broke down and begged for an abortion because I didn't meet the criteria for miscarriage management for another 10 days (following my rescan).

I don't have anything to say that will change or help how you are feeling right now but all I will say is that whilst I completely fell apart, had two months off sick and very nearly did some serious damage to my marriage a year on the pain and the confusion and the torment has gone. It will end and we actually managed to get pregnant again as a total surprise 2 months after my surgery!

You both have my deepest and sincerest sympathies xxx

Just to add sorry, I opted for the surgical management of MC when I finally met their criteria and if that is something you think you would opt for I can give you some info on it 💕 x

@mrsrose2018 please give me some information. My husband is a doctor and is against intervention of such nature if I can use pessaries. But I think if I have to keep going back to have scans for monitoring until it passes naturally, that will break me. So I really want to convince him on this as he does understand it is my body at the end of the day but is very cautious on any interventions without necessary need. I want to convince him this is necessary for my mental wellbeing

@Furbsies absolutely!

May I also ask what kind of doctor your husband is?

So in general you have 3 options for management of miscarriage:

• expectant management: you wait it out and it takes between 1-14 days so they say but I've heard someone saying it's longer than that! I've also heard that with an anembrionic pregnancy the miscarriage process isn't exactly the same as a "typical" where they was an embryo that sadly died. It can be even longer...

• medical management: like you said they give you medicine to help you pass the sac etc. I'm told this usually works within a few hours and my hospital you had the option to stay in hospital or go home. Personally there is no way I could have managed this option! I'm told it comes with what's essentially a very heavy painful period and clots and CAN last up to several weeks before it's over.

• surgical: my hospital never called it a D&C but I've heard other women call it that - my mum also did (she had a MC and this procedure before she had me some 30 years ago). I believe you are offered both a general or a local aesthetic but my hospital just put you to sleep. I went in in the morning, they have me this tablet to put under my lip to soften my cervix, i said goodbye to my husband and woke up 3 hours later and it was all over!

Everyone from the nurses, to the anaesthetist to the doctor performing the surgery were WONDERFUL! I get really bad white coat fever so they gave me a little sedative to calm me/lower my breathing and heart rate, chatted to me till I went under and I got some pretty nice painkillers when I woke up! My husband came and sat with me till I was able to be discharged - standard eaten something and had a wee - and I was home and in my sofa by the end of my he day!

I only had light bleeding for about 3 days after, not even enough to fill an entire pad, but I did have strong stomach cramps/period pains but a good dose of cocodamol and a hot water bottle made me comfortable! I wouldn't even say it was as painful as my worst period!

Finally I had to take a course of antibiotics but other than that I didn't have to see or "deal" with anything.

Now sadly my mental recovery was no where near as smooth and easy and it was probably the darkest two months of my life since I lost a parent at 15 BUT I honestly believe it would have been so much worse for me to pass things naturally but that's just me!

Like your husband mine was very hesitant about me having the surgery! We actually had a bit of an argument in the patient room about it but essentially I told him that I was basically about to fall apart and whilst I understood how sacred he was about this surgery it was an incredibly routine pretty minor procedure and I needed this! I needed 3/4 hours where I didn't have to think or feel or deal with the pain and the miscarriage and I wouldn't be able to handle the alternative! Thankfully he understood!

Sorry this is a very long post but I hope it helps you! Also I again want to emphasise that even though it doesn't feel like it now, eventually the pain will subside and then eventually pass (ish). I still think back to last year sometimes and whilst it's still sad we did recover and I am now 30 weeks pregnant (we weren't trying, this was a surprise).

Let me know if I can answer anything else for you xx

@mrsrose2018 he is a junior doctor in respiratory right now. I have been spotting with slight increase in that but only by a few drops since 1st May and now its 13th... I'm not having cramps for now, just slight backache. I am now going to find some online resources on this so I can quote to my husband and tell him that I won't be able to wait it out for so many weeks.

I do think if this spotting/bleeding is to go on any longer than a few weeks and it is a MC I will be broken. I'm good with most situations. I too lost a parent, my mum when I was 20. She sadly completed suicide. And I am scared to be going down a downward spiral of blaming myself. Took me a few years to pull out of that one and I just couldn't bare it again.

Thank you so much and it's nice to hear that after a loss you managed to get pregnant and that too as a surprise. It's very encouraging and gives me hope for the future. It's been really helpful.

@Furbsies

This is the patient information leaflet of my hospital:

mft.nhs.uk/app/uploads/sites/4/2018/04/Surgical-management-of-a-miscarriage-April-2018.pdf

It lists the risks of the procedure and gives general information!

With the absolute utmost respect to your husband and everything he does, he is still relatively junior and respiratory medicine is very very different to obstetrics and gynaecology and whilst I'm sure he did a rotation I would try and speak to someone within that speciality!

Also this is ultimately your body and your decision and he is allowed to be scared and disagree but you have to do what's best for YOU because only you has to live in your body!

I'm so sorry to hear about your mother and whilst I didn't utilise any of the services there are lots of support lines and forums and people you can talk to if you need them! X

@mrsrose2018 thank you so much this has helped. I have checked out info in the link as well.

Discussed it with my husband now. Considering they won't let him into the hospital and I'm likely going to need to decide what I need to do when I'm in the appointment.

Husband has accepted it is my choice and my body at the end of the day but has also decided for his own satisfaction he is going to go and speak to some specialists in this area to understand risks and complications of all the methods involved.

I was doing so well but now I find my self counting the days/hours/minutes down till this scan and also somewhere deep within still have a tiny bit of hope.

@losingthettcplot how are you doing?

@Furbsies cramps are there periodically but no bleeding yet. I can see me going to my scan next week and having to have some intervention. I’m going to push for something next week as I want to get on with it.

Hoping that I can get a D&C as don’t want to miscarry at home really.

I keep telling myself it’s an empty sac and I’m just on a normal cycle and I’m just waiting for AF to show.

How are you doing? Xx

@Losingthettcplot i feel the same, I just want it over and done with now. I definitely don't feel like I want to go through a MC at home either.

I'm not having any cramps but just unable to keep any food down, and continuously spotting. Which is slowly increasing in quantity.. Hoping this is over soon. The body is strange in playing tricks. Mostly angry at my own body for making it so difficult.

The scan couldn't come fast enough...

@Furbsies hope is natural..

I don't want to tell you not to have hope but the way I approached it was to go in accepting it was a miscarriage and there was no chance of viability because that way if it was a date mix up then that was incredible but if it wasn't my hopes wouldn't be dashed again

I say this is how I approached it, this was only approaching my final scan that I changed my thinking as I genuinely went I every scan and blood test hopeful and thinking it would all be alright... so for two weeks it was like finding out I was going to miscarriage for the first time every time!

I think that's very sensible of your husband and a good idea!

When is your scan/do you need to make a decision?

@LosingtheTTCplot hope you are ok as well! So sorry for you as well xx

@MrsRose2018 thank you for all your info. It’s really informative.

@Furbsies I started with brown spotting this morning so hoping this is the start, feels strange to say hoping for a miscarriage, like a bit inhumane. But I know the sac is empty and I have to keep telling myself that. Trying to think of it as a delayed period. Xx

@Losingthettcplot i am so sorry. How are you feeling. I completely understand. My spotting has increased and decreased several times in the last few days and every time it has increased I've been like well its finally starting, will be over soon. So I understand. Its not inhumane. Its very normal. I feel the same
If it is empty then I just want this to be over

@mrsrose2018 yes hopefully I can understand the pros and cons and he can feel relieved. I have my ups and downs but I think I've just accepted that it will turn out to be an empty sac and it's a MC. At least this way I won't be getting a shock.

My scan is on the 20th May. So 5 days to go.