Empty Sac 11 weeks... MVA?

[mooskimoo]

Hi, I had bad shoulder on tues and basically thought shoulder tip could be linked to ectopic so went in to my GP who booked me to go for scan at hosp to check all ok.
I was due to have my 12 week scan next week and all was fine until this shoulder pain. I had a ultrasound tues eve which showed an empty sac but it was in the evening snd there was no sonographers available so we went back the next day for an internal ( at 11 weeks )
The internal showed an empty sac- measuring 27mm and no yolk or embryo.
My HCG levels are 19,000 so with this size sack and those levels it is most like I have had a MMC.
I am certain of my dates and even if I was
A couple of weeks out. The size of sack and it being empty indicate there was never a baby there. Especially as the internal
Can show a heart beat from 6 weeks...Just seems pointless having to go back in a weeks time
For another scan.
I then have to decide how to remove the remaining sack... I am thinking MVA as I want it over with ASAP.
Has anybody had experiences similar to mine that could offer me any advice or support? Words of comfort, not horror stories please...
Thanks
Xx

I’m so sorry for your loss.

I had very similar in July. It was three internal scans I had before they could positively say I’d had a mmc. This was over a period of three-ish weeks I think.

I went for the first scan at 6.5 weeks.

I did try medical management twice but my body didn’t respond, so I ended up having surgical management at exactly 10 weeks.

It’s all shit, but after the surgery, & the hcg left my symptoms I did start feeling better emotionally. The hormones had a lot to answer for.

I had a positive pg test 5 weeks later, & I’m now 19 weeks pregnant today.

Again, I’m so sorry.

Thanks for your message. From what I have read I am leaning towards going for MVA in the first instance. I know it will be painful but either option will have some pain and it's less prolonged pain than the MEdical management from what I have read. Was an MVA not offered to you? How did you find the surgery? Glad the surgery worked and you were able to start TTC again soon xz

Hi OP. I had an empty sac (blighted ovum) at 13 weeks, missed MC. Opted for an MVA, worked great I have to say, I just felt a bit sore for 2 days and had a bit of bleeding but absolutely nothing major. That was my third MC and tbh had I known what I know now, I would have had MVA on previous occasions too. I am now expecting again so we'll see how this one goes. Sorry for your loss and best of luck xx

@mooskimoo it was the same procedure, only under general anaesthetic instead of local.

Emotionally I couldn’t deal with local. I wanted to be asleep when it happened. Recovery was absolutely fine, once I woke up they gave me some pain killers but I didn’t really need them.

There was a bit of bleeding, which is the same as you’d get for local anyway.

Also it is completely normal to have several scans in the case of suspected MMC, these are the clinical guidelines and it's done to be absolutely certain the pregnancy isn't viable. It's hard, I know, but ultimately done for good reasons xx

Thanks Sansa. I was initially thinking general but currently in my local hospital the women's health ward is closed due to a Covid outbreak and I don't know where I would be placed to recover, I also like that my partner can be with me for the local and I can go home soon after. Am really hoping I recover well from it snd it's all over quickly. Fingers crossed all is well for you. X x

Thank you Purplepansy. I understand having to wait for re scan but when the sac is so big and empty and deffo nothing there it seems pointless dragging it out. So glad to hear your MVA went well. I have also found out I have a tilted cervix.. retroverted I think.. do you think this will impact how they can do the procedure ? Am really hoping all goes well for you this time xx

I have tilted cervix too. It has no bearing on MVA at all, don't worry. I hope it goes smooth for you and that you will recover well. It's not a nice situation to be in at all. Xx

I would say use the time now to make yourself as comfy and prepared as possible. Get some sanitary pads (and bring some with you to the procedure just in case). Take a day or so off, get yourself some books and treats for your quiet recovery time. This will help you get through this a bit easier and it means a lot long term xx

Thank you so much @PurplePansy05 , this is all really helpful. Could you possibly describe the procedure to me so I know what to expect ? How long did it take ? I am glad my partner can be there with me and can use gas and air, did you use it? I think I'm ok with pain- fine for smears , needles and bloods taken efc.. and was ok when I tore ligaments in my ankle and went to a&e ( this was very painful- I almost fainted and saw stars) also I had breast reduction surgery and found that manageable but quite sore after,... only used paracetamol tho.... do you think I will be ok? Thank you so
Much for your responses, they are really helping me xxxx

Hello, so it was 15 mins, like a longer smear test really. You will feel that they've put something inside if you see what I mean, but you won't see any awful images, blood or anything. I didn't have to use gas and air all, although it was offered. I have a high pain threshold following years of bad AFs and 2 MCs before. But honestly, if you're struggling, gas and air is there and will help you. If I can suggest something, talk to your DH about something nice and completely unrelated throughout, it really helps. I had to go in on my own in the summer this year and coped just fine, was chatting to nurses and the consultant. I was advised to take ibuprofen the morning of my procedure (which was first thing in the morning). They will give you a tablet called misoprostol prior to the procedure as well, it's for loosening things up down there. I wasn't given it because I had a history of bad experience with medical management before (with mm you take 4x misoprostol and I reacted very badly). However, with MVA you only get one tablet so I wouldn't be concerned about it. Honestly, you will be completely fine, especially with your DH being there. I was given tea and biscuits after and an hour later I was out. The whole appointment in total took about 3 hours. Is this your first loss? You may want to enquire if they'll offer genetic testing of the pregnancy tissue, they may not if it's your first loss, but if they do, they should take a blood sample from you following the procedure to enable the testing.

I only had to take painkillers once or twice in the week after and had some spotting/bleeding then and a heavy feeling low down for a bit, but it wasn't worse than period pain for me. You will be fine lovely. Xx

One more thing, I'm sure they'll tell you, but be careful when you get up first thing after the procedure, do it slowly and tell the nurses asap if you're feeling dizzy, it just means that you need few more mins to make sure you don't faint. Ultimately it is an invasive procedure so your body may need few mins to adjust straight after xx

Thank you so much @PurplePansy05 this is all so helpful and will enable me to prepare more for it. This is my first loss so I will enquire but won't hold out much hope incase they don't offer it for this. This was also my first pregnancy. I am so glad we didn't get to the 12 week scan and find out then, that would have been awful.. it's odd how these things happen for a reason, like my shoulder pain wasn't actually related but it did lead us to getting the scan so we could find out before... only a week before but still, we weren't going to a 12 week scan all excited and to find out then that nothing was there. Do you remember what size your gestational sac was when they said you had blighted ovum? Or your hcg levels? I really hadn't heard of this before so it is all a bit shock to us.. xx

No, it's in my notes but I can't remember. It is perfectly possible the baby was there originally and has been reabsorbed after it stopped developing, hence the empty sac, or it has never developed properly. Most of us don't find out till the booking scan, there's no way of knowing before unless you have an early scan. Blighted ovum is not uncommon, it is likely the cause was chromosomal xx