Is This Normal?? Natural Miscarriage - No Ultrasound, Exam, or Bloodwork @ Follow-Up Appt.

hk0908

I found out at my 12.5 week appt. that my babies had no heartbeat (identical twins, one sac). They both were measuring about 9.5 weeks. My doctor gave me the option to schedule a D&C or to pass them naturally. I was in no shape mentally for the D&C, so I decided to proceed naturally. I bled off and on heavy for about a week…I passed the babies and a lot of tissue the first night I started miscarrying. A few days later I ended up in the ER from losing too much blood over a span of a couple hours. Then finally, a few days after that, I passed the biggest (size of a human heart) piece of placenta, which appeared to have the end of the umbilical artery/veins attached? It was bizarre. I felt this weird pressure the day before and had a hard time emptying my bladder completely. I guess that was the problem. I stopped bleeding shortly after that.

So I finally had my follow-up "appt" today. My doc ran no tests at all - no ultrasound, bloodwork, or exam. Is this normal? He seems pretty sure that since my bleeding stopped, I passed everything on my own. I just feel like I need some confirmation that this is over and my body is slowly getting back to normal. What did your doctor do at your follow-up???

For anyone having to go through this, I'm so very sorry. It is truly heartbreaking and by far the hardest thing I have ever had to deal with.

twointow83

If this is your first loss it is not uncommon for docs to not seek answers unfortunately. As for as the rest (u/s, hormone levels, etc.) that varies doctor to doctor. For example, my OB has run the spectrum of "why?" tests and pre-op D&C bloodwork but has never ran my levels or done u/s after... with either of my losses. I have been using cheap (walmart $0.88 tests) to test my hormone levels out of my system. It's been a slow process for me (may not be for you, though) but I finally got a BFN. Now I am using OPKs (internet cheapies) to make sure the line keeps getting lighter (for me no test line=0 hcg or LH... some people have a line regardless all cycle long and if this sounds like you then this may not work for you). At this point I am nearing zero as my test lines are pretty faint. My point is, if you can't get your doc to run bloodwork or anything, and if you can emotionally handle taking the tests then this is a viable option to reassure you that your hormones are decreasing (retained tissues could mean your levels remain high). Also, watch out for super heavy bleeding or a fever as these can also signal a problem. (((HUGS))) I am sorry for your loss

hk0908

@twointow83 Thanks for the kind words and info! The normal bleeding has stopped, but when I had a bowel movement today (sorry - TMI) I noticed a little bit of dark red blood/brown discharge. I guess that isn't a big deal and it's just slowly tapering off? This is all so new to me...

twointow83

You are welcome, I am happy to help. I know how confusing it can be, esp in a weaken emotional state.

That is completely normal- 100%. I don't know if it is pushing or muscle contractions of the bowel, which is directly behind the uterus, but it happens to me all the time- even with run of the mill AFs. Some residue/leftovers get shook loose, so to speak. But it is nothing to worry about Also, so you don't get caught off guard... don't be shocked if it disappears for awhile and then comes back... With my first loss I stopped bleeding for over a week and then it came back full force. This time once it stopped I have mostly been having spotting on and off. Either way is normal. The only ABnormal thing, bleeding-wise, that you need to watch out for is if you fill a pad in an hour or less continuously for more than 2 hours, like you had before, which could indicate an issue... but don't panic if you fill ONE pad in an hour or less as this can happen if you pass a large clot... but if it continues def call your doc or go to the ER.

hk0908

Thanks! I feel much better. I'll buy some cheap home pregnancy tests tomorrow and monitor my levels. Can't wait to start trying again! Best of luck to you, and I'm sorry for your losses as well!

twointow83

Best of luck to you too and thank you. Since you are planning to TTC again you might want to consider getting some tests (internet cheapies) from ebay or saveontests.com. Saveontests.com's tests are reliable, I've used them before when TTC'ing and it always gave me an early BFP (9-10 DPO) and never had a false + or an evap. I can't vouch for all the varieties on ebay but clinical guard is reliable as well. I'll LINK you to the seller I bought from on ebay. The clinical guard ones are darn good too! It was a barely there line (the kind you have to get someone else to look at to make sure you aren't seeing things BUT my HCG was less than 13 the first time I saw something.I tested and saw something for the first time @ 9 DPO and I didn't get a blood test until 11 DPO which is when it was only 13... so God only knows how low it was at 9 DPO... I'll post a few pics of each kind of test results so you can see for yourself, in case you are interested.

saveontests' brand:
10 DPO... didn't get blood work for a few more days but it was already nearing the 200's by then so I can't tell you what my HCG was... based on the whole "doubles every 48 hours" bit I'd guess it was in the ballpark of 20 or less


Clinical guard brand:
9 DPO. it was easier to see in person.. this is the best pic I could get of it.

10 DPO HCG <13 still pretty faint so you prob won't see a line if you are on your phone...


The "run". I pictured 10 DPO by itself because I had a bright idea to put tape all the way across the test to preserve it and as you can see... it only damaged it. Also, you can't really see 9 DPO in this pic so I pictured it by itself as well.

jak1977

Keep an eye on the hpt. I'm almost 7 weeks from my mc (i was also 12 weeks) I called doc because I tested pos. On a hpt 6 weeks after mc. I never had my cycle and didn't know if it was a new pregancy or hormones from the mc. I wish I did the hpt after the mc because then I would know more. My doctor also did nothing after the mc.
Now, because of the pos. She did blood work. My hcg Thursday was 76. They said that was too high 4 being 6 weeks post mc. Then I had a painful period for 1 day after I had blood work done. I now am waiting 4 another round of blood work and trying to figure out if that was a period...more of the mc.....or a new pregancy that was a mc.
Sorry 4 the long story...
if your doctor's not doing anyrhing...take hpt weekly. If they are still pos. Agter 4-6 weeks call your doc and request blood work.
From what I here and read...they should be neg. After 2-4 weeks in most cases. If you were farther along...as we were...then it could take up to 8 weeks to get a neg. And have the hcg levels return to 0.
Hope my vent helped. ;-)

twointow83

Also... I recommend saving your tests if you test more than once a week(date them so you know which is which) so you can compare. Once a week there will be a bigger difference so you may be able to see without saving the tests, but even then you might like to compare to see how big the difference it. If I had JUST looked at my tests I wouldn't have seen a difference at all because it was so gradual(then again I tested every other day 'cuz I'm just plain paranoid lol) and being able to compare made it easier to see a difference. Just don't compare a wet test to a dry one. When they are wet they look darker than when they are dry. Let the new one dry out before comparing to the old one. HTH.

These are mine. The last one isn't dated because it was a BFN and I switched to OPKs after that (the line you may see is an evap)


My OPKs aren't dated because it's hard to write on the tiny buggers so they are taped together, but as you can see the OPKs can be used after HPTs can't anymore to keep an eye on your levels. The first few are really dark because I used them on the days in between HPT tests so I could have a baseline for when I went to not being able to use HPTs... that and I am a POAS addict lol

twointow83

Sorry I am blasting you with so many pics btw... I am just a visual person and things make more sense if I can SEE what people are talking about. Without that it's all abstract to me. I don't know if you are the same way but I figure it can't hurt

MayBeSomeDay16

I never even saw my dr. The day i started having bad cramping and bright red blood i called the dr's office and they told me to go to the ER. So i did and they confirmed i was MC. My bloodwork was at 43. The ER told me to call my dr. the next day to see what they wanted to do. When i called they said "your all set if you passed tissue" um OK, don't you want to have any bloodwork done to confirm i'm lowering. "Nope". I am no longer going to that OB for anything, not even my annual Pap. I really needed to talk to a dr or NP about the MC and i got no support, no, this is what may happen with you cycle/body. Nothing! 

I'm 8w 3d out from my MC now. I started using cheapie ebay HPT 3 weeks after MC and at that time they were negative already. Got my AF exactly 5 weeks out.

@twointow83 I appreciate the visuals. 

peevpee

I am currently waiting for my miscarriage to happen. my baby died about 2 weeks ago and I am not even having spotting yet. when I refused d&c and the magic pill, my doctor told me that I need to come back after I stop bleeding completely for an ultrasound, to make sure there is no tissue left. she said if any tissue stays in there, I might develop infection.
so I think you should go get ultrasound.
by the way, how long does it take to miscarry naturally? as I said, it has been two weeks and I am not spotting or cramping yet.

MrsGargoyle

peevpee said:

I am currently waiting for my miscarriage to happen. my baby died about 2 weeks ago and I am not even having spotting yet. when I refused d&c and the magic pill, my doctor told me that I need to come back after I stop bleeding completely for an ultrasound, to make sure there is no tissue left. she said if any tissue stays in there, I might develop infection. so I think you should go get ultrasound. by the way, how long does it take to miscarry naturally? as I said, it has been two weeks and I am not spotting or cramping yet.

Be very careful with MMCs. Missed m/cs sometimes occur and it just takes time for the body to break down and prepare to release the baby. Other times, however, the body fails to get the message and the placenta keeps growing thinking that it is supporting a living baby. When this happens, many weeks can go and nothing happens. Sometimes, when something either happens naturally or through the use of Cytotec/misoprostol the result can be far more painful and traumatic than even doctors anticipate. One of my losses went this way and I still deal with PTSD-like symptoms. I am not telling you to scare you, but to say that the longer you wait, the more strongly I would suggest reassessing the need for a D&C. D&Cs carry risks, but the risks are low and being under general anesthesia is a blessing. If you do persist in desiring to pass things at home without intervention, I would strongly suggest that you contact your doctor for prescription pain meds to take when it does happen, and to get specific instructions on when to go straight to the ER if things are getting out of hand. Do not be afraid to be a strong advocate for yourself. Best of luck moving forward. I am so sorry for your loss.

hk0908

@peevpee according to my ultrasound, I went 3 weeks not knowing that I had miscarried. I started bleeding a few days later. So it took my body 3.5 weeks to realize. Once I started bleeding, it lasted about a week. I never had horrible pain like some people have. I was fine with Advil. But everyone is different...that's one thing I have learned from this message board. You will make the best decision for you. For me, I knew it was a natural miscarriage. Also, I did not take any meds to move things along. I heard those can be pretty painful. Hope this helps! I am so sorry for your loss.

hk0908

@MayBeSomeDay16 this is exactly how I feel! I just want some sort of confirmation that it is over and my body is getting back to nonpregnant normal. I am definitely going to start taking tests at home until they are negative.

@jak1977 I hope you get good news that you are already pregnant again!

@twointow83 thanks so much for all the great info and pictures! I will definitely be monitoring my hormone levels. I can't wait to try again! Although, I miss my babies and I always will.

Good luck to all of you!!!

twointow83

peevpee said:

I am currently waiting for my miscarriage to happen. my baby died about 2 weeks ago and I am not even having spotting yet. when I refused d&c and the magic pill, my doctor told me that I need to come back after I stop bleeding completely for an ultrasound, to make sure there is no tissue left. she said if any tissue stays in there, I might develop infection. so I think you should go get ultrasound. by the way, how long does it take to miscarry naturally? as I said, it has been two weeks and I am not spotting or cramping yet.

My recent LO passed at 7w 4d and I started bleeding the day before my D&C about 5 days later. My first was a very diff story. He stopped growing weeks before we knew he was gone and I never had a clue. Each woman and each preg is different. I'd call your doc to see what s/he says but I don't think you are in any immediate danger at this point... I am no doc though. The one that was gone weeks before we knew had an infection in his bag of waters but thankfully it didn't spread to me. Er on the side of caution and call your doc though, plz.

twointow83

Glad to help and just for info purposes, my OPKs didn't go stark white this time on me. The last test in the OPK "run" (blue) pic was yesterday's test and today I am surging so obviously my HCG was already at zero because my body wouldn't be gearing up to ovulate if not. Miscarriage makes things wacky so it doesn't surprise me much. I thought I'd throw that in there because I was waiting for a no-test-line test and it didn't work out that way. It may or may not work the same for you, just thought I'd give you a heads up

jak1977

I just had my next round of blood work. I hope it doesn't take a week again to get the results!!!
Im sure my.levels are close to 0. I am now showing negative on hpt.
But my body still feels out of order! I woke up at 5:30 today throwing up!!! Lol. Life

me1982

I'd ask your ob

jak1977

It's been 2 weeks now between bloodwork. My hcg went from 76 to 51. The lady said to wait a full week between test and it should go to 0. I said it's been 2. Lol. She doesn't know why it's taking so long. So she sent a message 2 my doctor.