Concerns About NHS Care During Heavy Bleeding at 15 Weeks Pregnant

[biscuitsndtea]

I had a very concerning experience recently, and I’m hoping for some advice or insight. I am currently 15 weeks pregnant ( via IVF) , and a few days ago, I had very heavy bleeding. I rushed to the nearby A&E at midnight, feeling extremely worried.

At the A&E, I was told they couldn’t perform a detailed scan because their equipment wasn’t adequate. Instead, they referred me to the Early Pregnancy Unit (EPU), which wasn’t open until the next morning. I had to wait overnight for the EPU to open, still bleeding and feeling anxious.

When I finally saw the EPU, they informed me that they don’t perform full scans either. They only check the fetal heartbeat. While they did confirm the heartbeat, they couldn’t provide any further answers about the bleeding or its cause. They discharged me without much clarity.

I feel like I was just sent in circles—A&E said they didn’t have the right equipment and deferred to the EPU, while the EPU said they couldn’t do proper scans and discharged me. It felt like I wasn’t taken care of properly during such a stressful and serious situation.

I did a private scan in nearby scan center - they said that I have low lying placenta but it's too early to say as it could move up later during the pregnancy. But they said they are not meant to provide any diagnostics as it's against their policy.

When i searched through the forums for low lying placenta , it looks they were admitted in hospital and monitored. I am not sure if I was treated this way as I am only 15 weeks now. Is mine a normal experience with NHS ?

I feel lost. Has anyone experienced something similar or have advice on what I should do next?

Sorry you had this experience, it's just awful not having answers from the people who are supposed to give you them. Did they check for a heartbeat? Was heartbeat normal etc? Without sounding harsh but trying NY to give you a real answer, from their perspective if you are miscarrying (which I pray you're not) then there's nothing they can do to stop it. All they can do is check if the pregnancy is still viable (as in heartbeat) and if it's not, put you on a pathway to deal with miscarriage, and if it is, just let you continue on as normal and hope that bleeding stops etc. They should have at least told you about low lying placenta etc, and there should be better explanations. I would give Epu a call again and just confirm that they can't look any further. Alternatively you could walk into a different hospital to A&E and try and go through their EPU or they may scan you in the spot.

Admission for low lying placenta is only for women who's placenta is completely covering the cervix in the last few weeks of pregnancy and usually then only.of they have bleeding/contractions etc.
If you were no longer heavily bleeding and your observations were normal then I don't see much else they could do, although it doesn't sound like they did a very good job of reassuring you

Oh and also, our hospital don't scan in the night either, the management overnight would be emergency surgery if you are bleeding significantly

The heart beat was fine.
The private scan confirmed the same and the baby was moving. So it's not a miscarriage thankfully!

I was still heavily bleeding while I was in the A&E and in the EPU. It was so heavy that I had ask for extra pad from the nurses and change in the hospital as the pad got soaked very quickly.

Hi @biscuitsndtea I'm sorry you're going through such a worrying time and hope all settles down for you. I can't answer everything but just wanted to give a few pieces of info in case it helps.
Did you haemorrhage? Heavy sustained blood loss would be admitted for observation from a maternal perspective ie to ensure you are not decompensating from blood loss. If you were stable then it would be common to be sent home.

I mean this with gentleness but at 15 weeks there is nothing they can do for your little baby so there wouldn't be much else to offer other than a scan to confirm a heartbeat. There often isn't anything else to see on a scan unless they could obviously see a haematoma maybe, but still nothing they can do. Did they mean in EPU that there was nothing else they could check for?

Low lying placenta isnt an issue at 15 weeks. Your uterus is still so small in comparison to your placenta which is quite big, so almost all will appear low lying at this stage until the uterus grows and placenta moves up with it. You wouldn't normally comment on position of placenta at this stage.

If you keep experiencing bleeding I would just keep presenting to get them to confirm heartbeat and get reassurance in that sense. Not that it's hugely reassuring overall but at least to know in that moment it's OK. I wouldn't really accept that a maternity A&E can't throw a scanner on you to confirm a heartbeat and waiting for EPU. At 15 weeks it's fairly obvious to see a heartbeat regardless of equipment so personally I would insist on someone doing a basic scan to confirm a heartbeat.

Thinking of you x

I’d be wanting progesterone pessaries OP. Can you speak to someone at your IVF clinic? I’d also follow guidelines for pelvic rest as much as is practical.

Sending strength and positive thoughts your way.

Really sorry you had this experience.

When I had problems at the start of my IVF pregnancy I was told to always ring the IVF clinic (NHS funded) before 12 weeks, and after 12 weeks to always call the midwife triage or out of hours service first.

This meant they could look up my records and get me sent to the right place. They then called ahead to EPU to book me in and warned me to take an overnight bag as I was going to be admitted for a few days (this was with severe OHSS).
Likewise for heavy bleeding they told me over the phone they don't scan in epu and only listen for heartbeat, it did mean I could wait at home until the time I was booked in.

Unfortunately at my local hospital it would be the same treatment.

Maternity assessment unit and triage will not see you before your 20 weeks. Only EPU will which is litterally just confirming heartbeat there's not much more they'll do

Thanks for the reassuring messages xx

@Puddlelane123 my IVF clinic discharged me as it's over 12 weeks
What does pelvic rest mean?

Hi @biscuitsndtea I'm 22+4 with an IVF pregnancy. I first had a SCH which resolved by the dating scan and now I have placenta previa. My local trust usually checks the placentas position at the anomaly scan, however I was aware earlier as I'd specifically asked (as I worry and looking into things). If you still have placenta previa at your anomaly scan they should refer you for additional appointments and scans.

I was on progesterone for bleeding caused by the SCH after being discharged from the IVF clinic. The IVF clinic had me on injections and pessaries. The NHS prescribed me pessaries to cover up to 16 weeks. Pelvic rest is no sex, it can even mean as far as no orgasms from external stimulation. A lot of people will suggest taking it very easy, such as limiting exercise, lifting, bending, squatting etc. I am doing this now as I don't want to take the risk of further bleeds as I experienced them from the SCH. Most placentas move up out the way so I truly hope we're the lucky ones.

As for the hospital's management of your bleeding. If you were bleeding heavily enough I'm sure the A&E would have done more. I had a miscarriage before where the bleeding was so heavy I went to A&E in the middle of the night. I had two doctors poking around inside of me trying to stop the bleeding. It was truly traumatic. They ended up having to take me for surgery right then under general. You can be hospitalised for bleeding from placenta previa even at 15 weeks, but this would be based on the checks they do and the level of blood loss. There are some great support groups for placenta previa on Facebook you may want to look at.

I had low lying placenta at this stage that has moved up nicely it's very common x

Sorry you’ve had a negative experience. Like others have said, unfortunately there isn’t anything they could do at 15 weeks, and likely didn’t mention the placenta as it hopefully will move up. I wasn’t aware of my placenta position until I was 20 weeks, so I’d imagine they’ll discuss it with you then - but like others have said, it isn’t something to be admitted for until you are close to birth if it hasn’t moved.

In terms of the bleeding, in my experience of IVF (I’m 38 weeks with ivf baby), synchronic haematomas tend to be really common. I had one that showed on my early scans but disappeared with no bleeding, and others I know (in fact the majority) had them and bled - some bleeding just once, others bleeding badly and regularly. They were described to me by my clinic as a bruise, which makes sense given what your body goes through in IVF.

The weeks leading up to your 20 week scan are by far the most stressful and drag out, particularly after IVF. I don’t think I started to enjoy or accept my pregnancy until I was 24 weeks, always thinking it would go wrong. What I will say is that you are past the most risky part now, and that if you try to take each day as it comes that it does get easier. I had a number of early scans due to anxiety, but what I did realise is that they only give one snapshot in time, and don’t give any prediction to the future, no one can. It’s really hard but pregnancy is just one of those things that will either work and be fine (the majority of time!) or it won’t (and likely for a reason, like baby wasn’t well or something).

Sending hugs, hang in there. Take each day as it comes and try and rest if you can while bleeding. Deep breaths.

How are you getting on OP?