EPAU telling me to wait?

[Shahhhh]

Hi friends 💛 first time posting on this thread.

Basically I miscarried in April at 7 weeks, passed naturally. I'm currently 5 weeks pregnant today and we had some blood when I wiped yesterday with a tiny little clot. I've had twinges and mild cramping from about 4 weeks pregnant, so that's not unusual. We were told by the early pregnancy unit that if we get ANY blood whatsoever in a new pregnancy we're entitled to Progesterone because we've already miscarried.

I spoke to them today and they are now saying I have to be at least 7 weeks and have to have a scan before I can get progesterone. They didn't mentioned 7 weeks at all last time. I'm calling my GP tomorrow to see if I can get it through them as I was assured last time I could get it.

I'm so scared of it happening again and this is exactly how it started last time, spotting then a few days later full heavy bleeding. Does anyone have any experience with this?

The hospital were close to doesn't have the best rep and were considering using a hospital a bit further out because they were not helpful at all in the last miscarriage and this time is kind of showing the same thing from them. It's so frustrating and really taking a toll on me physically and mentally that they just seem to be brushing me off and telling me to "take another test in 2 weeks and if you're still bleeding come back". How is that fair or humane?

Any advice? Thanks guys x

Sorry you are going through such a scary time. The NICE guidelines do recommend progesterone for women who have had both a previous miscarriage and bleeding in the current pregnancy. It is important however that you have a scan before progesterone is started to check for a intrauterine pregnancy with a heartbeat and that the pregnancy is not ectopic or PUL pregnancy of unknown location- it would be dangerous to give progesterone in these cases. There is no set timescale to start it but at 5 weeks there is very little to see on a scan, which is why I'm guessing they want you to wait until 7 weeks when they can see a heartbeat on scan. I know the wait is torture. I would get in touch with your GP on Monday to see what they think and if they could refer to EPU to get a scan at 6 weeks say, when lots of foetal heartbeats are visible (but not all). I have attached the guideline below for you to read and quote to the hospital if necessary (hopefully not), page 28-29 is relevant for you. Really hope you get sorted and that it's a good outcome 🤞

www.nice.org.uk/guidance/ng126

Hi

I’m sorry I have no advice but just wanted to say I’m going through something similar at the moment. Had a MMC in December and have started bleeding (spotting, but now heavier) this weekend at 6 weeks. I’ve self referred so waiting for them to contact me on Monday but from what I’ve read online I’m not sure how much they’ll do.

It’s an awful time isn’t it. The mental impact of not knowing is heartbreaking.

Hi! I’m so sorry your are going through this I am currently in the same position as you with regards to the progesterone.
I had a miscarriage back in January and one in may then found out I was pregnant at the start of July, I’m currently 6+1. I had a bleed two weeks ago and EPU told to take a pregnancy test in a weeks time and come back if still positive, which it was but that week was awful . I then had hcg bloods done and everything was rising well but they told me until they confirmed I had a viable pregnancy at 7 weeks they could not prescribe me progesterone.
I paid for a private scan yesterday and got to see my a babies heart beat and that’s after several spotting/bleeding episodes because I couldn’t wait for the EPU scan. Maybe try and ring them and demand more hcg tests as this should give you an indication what what is happening in your body. I completely understand how you must be feeling, I got to the point where I said to my partner ‘I don’t even care about the outcome now I just need to know’ I hope everything goes well for you thinking of you xxx

I had light bleeding at 6 weeks, after a natural MC last year at 11 weeks. EPU saw me for a scan and they could see heartbeat, and could also see a tiny bleed which explained the spotting. I didn’t get offered progesterone. I’m now 31 weeks. Most miscarriages are caused by a chromosome issue which unfortunately nothing can be done about, progresterone wouldn’t change this

At 5 weeks a gestational sac will probably be visible, if not hcg bloods done every 48 hours can determine if the pregnancy is likely intrauterine and progressing normally if not. Absolutely insist on being seen asap. Progesterone now if the pregnancy is in the correct place is your right with your history . Good luck

Hi! I had something similar, I've had 4 miscarriages in the last 2 years with the last being in January, when I was pregnant in Jan I went round in circles asking for progesterone but no one would give it to me. I miscarried naturally at 6 weeks. All my miscarriages have been before 8 weeks. I found out I was pregnant in June and I called a different epu and they put me straight through to gynae recurrent miscarriage and the consultant prescribed me progesterone and arranged a scan (which I've since had, I was measuring 6+5) im nearly 10 weeks now and I have a scan on Thurs to check all is well. Maybe ring a different epu/gynae?

Thank you all so much for sharing your stories 💛 I'm definitely going to push with the GP tomorrow and if that fails in the next couple of days I'm going to reach out to a different unit at a different hospital because I feel really let down at the moment. I was so scared getting pregnant again but felt confident I'd be looked after but again, just feel like I'm being pushed to the side. Thanks guys xxx

hi @Shahhhh I think 5 weeks is too early to see anything on the scan (which you’ll need for the progesterone) so that’s likely why they’re making you wait. it could be they say 7 weeks at your EPU to account for dating discrepancies? sometimes people think they’re further ahead than they are & then if nothing is seen on the scan it can cause even more stress and worry.
I had a bleed but I was 6w+1 so my EPU did a scan and could see the heartbeat and the bleed. I hope your GP can push for at least 6 weeks to put your mind at ease 🤍

https://www.aepu.org.uk/find-a-unit/

A walk-in EPU will usually see you at any number of weeks if you have bleeding and/ or pain. If you're definitely over 5 weeks they should at least be able to see the location of the gestational sac and check your lining thickness.

Thanks so much everyone 💛 I saw my gp yesterday who was the one who saw me in my last miscarriage which was nice as she knew exactly what happened last time. She got me in at the maternity ward and I have a scan on Sunday! Fingers crossed and taking one day at a time x

how did you get on @Shahhhh ? hope everything is going okay 🤍

@cherrybl0ssom5 we had our scan on Sunday and saw a lovely little heartbeat at 6+1 🥰 they've given me progesterone to take up until I'm 16 weeks but everything was so smooth and lovely! Feeling a lot more confident 💛 thank you so much for checking back in xxx

I'm happy you had a positive scan op, good luck with the rest of your pregnancy.

Just to add to the "when to scan" discussion - you definitely can see a pregnancy on a scan at 5 weeks. You won't see much (I only saw a sac) but if the pregnancy is intrauterine that will be pretty clear to see.

It's Kafkaesque to say "you have to wait till 7 weeks and we can see a heartbeat" before you can have progesterone when perhaps the woman needs progesterone to be able to get to that point!

oh my gosh i’m so happy for you that’s great news @Shahhhh !! 🤍