Frustrated: waiting to miscarry (help--waiting vs. Cytotec vs. D/C)

zzyyxx

Hi, everyone,

A week ago I found out that I would miscarry. I have a yolk sac measuring 10 mm and a small fetal pole with no heartbeat. They think development stopped somewhere around the 5th week, although I am supposed to be entering my 9th week. The confirmed all this in a devastating u/s a week ago after I had some cramping and came in for an emergency ultrasound. Laying on that table while they tried to find a heartbeat was one of the most awful feelings ever. 

 I decided to see if things would progress naturally and gave it a week. Nothing happened. I went in for my follow-up yesterday and had to go through the awful ultrasound process all over again. Even though I knew they were right the first time, I still had some morsel of hope that they were wrong. So, even though I was prepared, having to have it confirmed all over again was pretty terrible.  I just still feel so pregnant and have all the pregnancy symptoms that it is hard to wrap my head around it. 

 At this point, I am trying to figure out what to do. I can continue to wait a little longer (physician fine with this), but frankly if development stopped nearly 3-4 weeks ago, this should have happened a while ago.  I have had no symptoms that anything is forthcoming, aside from some lower back pain. While I really hate both options (medical vs. surgical) that are being presented to me, I also hate this limbo feeling and, emotionally, it is wearing me down. I seem to only feel really sad, really angry, or really numb. Ugh.

I am  scared of the D&C and the possibility of scarring, even though I have heard that the likelihood is less than 1%. It makes me really nervous nonetheless and I don't want to risk anything that could hurt future fertility.  My clinic offers two D&C options, the first a Manual Vacuum Aspiration (not a true D&C, but same result using vacuum) that they do with local numbing, but you aren't "out." They say that if you can tolerate a pelvic without a lot of pain, that you can likely tolerate this procedure, although it will be more uncomfortable than a pelvic and take about 10 minutes.

The also offer the traditional D&C with full anesthesia.

 They also offer the medical option of Cytotec. I had heard horror stories about Cytotec (worst pain ever, partial m/c still requiring D/C, higher rate of infection b/c cervix is open longer, etc.).  I also am nervous that the FDA has not approved Cytotec for this purpose (it is approved as a gastric ulcer med), although it has a long history of use for missed miscarriage. I wonder though if they have tracked long term implications of that use given that it is off-label. I don't really want to hear 15 years from now that Cytotec use is linked to some terrible cancer or damages long term fertility, you know?

Anyway, I had nearly come to terms with the D&C, but when I called to ask a couple questions of my on-call physician, she asked if I had considered the Cytotec option. She then said she had never heard of the really awful pain stories, that it was something they would want me to have narcotic pain killers for, but that it would be manageable. She also said that, since I am essentially  dealing only with 5 weeks of development, that it probably would not be worse than a bad period and she would expect that it would be complete and not require a future D&C. She said that it was the option that she would go with herself, and might be worth considering especially given that I am averse to unneeded procedures.  She also was not aware of the increased infection risk.

 ARGH.

So, after nearly making a decision, I am back to square one and just keep overthinking both and going back and forth. 

I'm tired. I'm stressed. I'm really, really sad. I just want this to be over, but I am worried that I will make the wrong decision. 

Any guidance, personal experiences, would be welcomed. And thanks, also, for letting me vent. 

 

 

zzyyxx

Ugh. And that was long and I likely sound like a paranoid, overly neurotic crazy person. That is, however, pretty close to how this is making me feel. Bleh.

MWoodside

It is really only your choice, obviously.  I'm sorry for your loss.

I can share my "story".  I was told at my routine second OB appt the baby had died.  I was 13w4d.  My body didn't recognize it and had not started breaking down the baby & placenta.  I am a person who usually always goes the natural route.  I am not into the medically-induced options personally.  I'm not judging anyone who does that, but for me it wasn't an option.  That is such a new use for those drugs so I worry about side-effects showing up down the road.

It can take weeks for the body to recognize a missed m/c.  And then weeks to complete the missed m/c.  I wasn't up for waiting another 6+ weeks, worst case scenario.  I needed this done so I could have the physical part over & focus on the emotional healing.  I chose a suction D&C.  I was put under.  It took 15 min.  It was a very physically easy procedure & recovery.

I wish you peace with whatever decision you chose.  Again, I'm sorry for your loss.

zzyyxx

Thanks for sharing your story, MWoodside. It is helpful to hear from other women that have been through this. I'm sorry for your loss as well and wish you all the best.

zzyyxx

Thanks so much, Mattsgirl, for sharing your story and I'm really sorry for your loss.  I'm also sorry you had to endure both the Cytotec and the D&C (talk about unfair). Best of luck to you.

Septmomtobe

Just wanted to let you know that you are not alone. I had a missed m/c confirmed on 3/29. I'm currently waiting for nature to take its course. My doctor said if after 3 weeks it hasn't happened I will have to have a d&c. They didn't offer any medication to help it along so I don't think they offer that as an option. While the waiting is killing me I am more comfortable with this than a d&c. This is my third consecutive m/c (after 2 healthy pregnancies) so I want to avoid anything that will add to my difficulty sustaining a pregnancy (ie scar tissue/adhesions). 

My first 2 m/c were natural at just over 5 weeks. The pain was more of a bad period but not horrible. I just took a couple motrin and was fine. My first was during my sons birthday party and my second at work in a training. No one had any idea anything was wrong. I say this to put into perspective the physical pain. The emotional pain of seeing the tissue passing was probably the hardest.

This is a personal decision and each person needs to decide what's best for them. I am very sorry for your loss.  

katelynsmom

I am so sorry you are going through this.  I did cytotec when my baby was measuring 6w4d.  I read all the stories online and I was terrified. But really, it wasn't bad. The cramps were a little more than normal period cramps. I could still walk around and be normal.  I passed most of it within 10 hours of inserting the meds.  I stopped bleeding for 3 days and then I had more cramping and passed some more stuff a few days after the initial meds were inserted.  All in all, I'm glad I chose this option. I did bleed for 25 days, but I might have done that with a D&C too.  I had a f/u with my Ob last week and everything is out. It was a textbook case. 

With that said, everyone is different and it's such a personal choice. I actually chose to try it naturally, but after 2 weeks, I just wanted it to be over.  GL to you!

April!

I had a very similar experience to you, including the timing. I found out at 7 weeks that my baby had stopped developing at 5 weeks, then ended up taking misoprostol at 10 weeks. I also wanted to avoid the possible complications of a D&C. It was more painful than a regular period, but nothing horrific. They gave me Percocet but I was still in quite a bit of pain and the Percocet gave me a horrible stomach ache.

I found this blog post really helpful when deciding what to do. https://babyburnham.blogspot.com/2008/12/my-experience-with-cytotec-misoprostol.html The comments describe other women's experiences with cytotec/misoprostol. My story is on there too.