EPU not doing 48h bloods?

[SunsetVibe]

I've self-referred to local hospital's EPU because I've already had 2 early losses, was told the next step would be a scan at 8weeks. I've asked to do 48h bloods for reassurance, was told no because they don't do them (??) 🤔 when I asked follow up questions on this and even mentioned a study I've read on how this can show signs of potential miscarriage I was told they only do them if there had been an ectopic.

I see people on MN saying they've had 48h bloods all the time. Did I just pick a rubbish EPU? I feel so disappointed, I've had 2 losses already, anxiety is at its peak, what if I need supplementation? 8w seems a bit late to find out.

I'm actually really sad about this, I feel like the lines are not progressing as if HCG was doubling, I'd expect bloods and maybe a scan much earlier. What's the point of calling them early on if they do nothing until 8 weeks?

Unfortunately the NHS can’t afford to do bloods every 48 hours unless there is a clinical need. I know this is a really anxious time for you but at this stage it’s just a waiting game. I’m not sure I would even recommend a private scan as very early scans can actually cause more anxiety. Waiting until 8 weeks means that if all is well with your pregnancy you will definitely see a heartbeat. Wishing you the best of luck 💐💐

If you want that kind of treatment then you will have to pay for it OP- a private clinic will be more than happy to do 48 hour bloods for your reassurance, the NHS won’t as standard. What they have told you is the correct protocol.

If you have a third miscarriage and are then seen by the recurrent miscarriage clinic this is something they can also potentially look at.

You need to go private.

The stories you'd see about 48 hour bloods would most likely be one of two scenarios. Someone is showing potential signs of ectopic or bleeding with a threatened miscarriage and need the bloods done to decide management. Or the other scenario, they avail of them privately for peace of mind.
Unfortunately having Beta HCGs done will only tell you what's happening right now but won't change an outcome or change management, and won't lend to supplementing with progesterone (I think that's what you mean but open to correction).
You'd need to have a work up done privately or else be referred to an NHS recurrent miscarriage clinic if you fit the criteria to have full investigations. Its often at those clinics that women discover they need progesterone in a future pregnancy.

Current guidelines suggest if you have any bleeding in a current pregnancy, and have had a loss before, then you should be offered progesterone. So contact them immediately if that happens (fingers crossed it does not).
Usual rules apply in that any bad pain or any bleeding you should contact them for advice. Otherwise the reassurance scan around 8 weeks would be standard.

I hope some of that is helpful. While I can totally understand you wanting the bloods for reassurance, the NHS doesn't have the resources to fund this when it won't actually change anything in terms of pregnancy outcome. I'd personally look into finding out your progesterone levels privately in case that has attributed to your prior losses, as its often something that needs to be started very early in pregnancy if it is found to be an issue.

Lastly I'm so sorry to hear of your previous losses and have everything crossed for a healthy pregnancy for you this time.

Having 48hr bloods is very unusual on the NHS and isn't used for recurrent loss reassurance. Unfortunately with 2 losses you really need to go private if you want the added reassurance tests done. Unless you have symptoms, the EPU won't really be able to do a lot. As PP has also said, the HCG numbers don't change the outcome or provide any treatment options. For me, I've had "good" HCG numbers 4 times, and they've all ended in missed miscarriage so it doesn't give you any guarantees I'm afraid.

I know it's hard, I've been there (and continue to be there!) but take a deep breath. Don't keep testing. Try to keep yourself distracted and busy until the 8 weeks scan. A lot of EPUs don't even do reassurance scans until you've had 3 losses so at least they can give you that.

I hope everything turns out well for you.

I only had regular bloods with threatened miscarriage. First lot were taken in A and E, second 16h later in epu alongside scan showing no pregnancy. As the pregnancy had never been observed they monitored my HCG until it was normal as it could have been a pregnancy of unknown location but unlikely as I would have been 10 weeks
Second pregnancy I had scans at 7.5, 9.5 and 10.5 weeks. First scan was 10 days behind, second no heartbeat follow up a week later to confirm loss
Third pregnancy I didn't know how pregnant I was due to no period between losses. They did my HCG to estimate when would be the best time to scan. They came back very high, I was scanned the next day at 8 and a half weeks. Progesterone started after the scan and I'm now 22 weeks!

Thank you all for your replies ☺️ I feel much better knowing that it's not standard to do 48h hcg. I thought it was because I see people saying that all the time, but you're probably right that it's either done privately or they've had bleeding or pain.

I do know it wouldn't change the outcome, but it could mentally prepare me for the worst if something's wrong again. Because my lines don't seem super dark, I'm actually scared of ectopic so at least bloods could help rule it out; and if was suspected then manage it before a potential ruptured tube and agonising pain :/

I might consider looking into doing HCG privately then, or might just hope for the best and patiently wait for the scan...

Thank you all again for the feedback, I definitely feel more reassured X

for may hospitals it’s policy not to do this upon patient request unless there are other issues. As someone who has had 2 ectopics they’ve not automatically done my bloods in the next pregnancy. In order to have bloods taken in my hospital you need to be presenting with ectopic symptoms or have had a PUL scan.

yes women do get them drawn but likely be due to pain/bleeding/PUL