# Possible miscarriage. Playing the waiting game is killing me.



## livysmom2013 (Jan 18, 2014)

So here is my story: My first pregnancy in early 2012 ended in a missed miscarriage. They did an ultrasound at 8 weeks and said the embryo was only about 6 weeks and no heartbeat. They did a subsequent vaginal us that revealed no heartbeat as well and hcg levels kept dropping. so at about 9 weeks I took the misoprotisol (sorry if that is not correctly spelled) to expel the embryo so that I would not risk infection. Well a couple months after that, I got pregnant with my now one year old daughter and had no complications with that pregnancy at all except some minor bleeding in the beginning. So now I am pregnant again and should definitely be at least 8 weeks and 5 days pregnant. I went today for my first ultrasound and they couldn't find a heartbeat. She told me I have a tipped uterus so that could be why but I had a tilted uterus last pregnancy too and they had no problem finding a heartbeat at 8 weeks....So now I have to wait for a few days to get a vaginal us and they started testing my hcg levels again. Also I failed to mention to the nurse that my pregnancy symptoms seem a tad lesser these last few days. She just asked if I had nausea and fatigue and I said yes, but I did not mention that they have gotten a little better the past few days and it seems too early to be having decreased pregnancy symptoms. So I really don't know what to think. Has anyone had anything similar happen? I was reading some stories from women who say they had no heartbeat at 8 weeks and went on to have a healthy baby. So now I am also worried that maybe I gave up too early on my first pregnancy and feel awful about that!....please no one sugar coat it. I'd like to prepare for the worse so please be realistic. How good do my chances look for this being a viable pregnancy???


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## livysmom2013 (Jan 18, 2014)

I forgot to mention they did a pelvic exam and felt that my uterus was enlarged and also saw an embryo that seemed to be about the right size. They just did not see a heartbeat. I have heard a tilted uterus can make it difficult to see the baby in general, but if they see the baby should they not be able to see a heartbeat too ( if one is there)?


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## Margo B (Oct 4, 2012)

This is the exact reason that no one should be getting routine u/s, especially in the first trimester. It causes so much worry that is often unnecessary. Are they doing repeat hcgs? I personally would almost never trust an ultrasound to diagnose a miscarriage. If your baby hasn't made it, your body will do exactly what it needs to do, when it needs to do it. I have not found any compelling evidence that there is an increased risk of miscarriage with waiting it out when the baby has stopped growing. There are certainly stories of women that were told to schedule a d & c or to take cytotec to expel the baby that then found out their baby was alive and well. Honestly, it isn't super likely if the baby were measuring small and no heartbeat later on, but still, it is a possibility and I there is almost never a good reason to induce a miscarriage, but it is hard to wait it out if you "know" the baby is gone, which is why I do NOT recommend an early ultrasound. And since your baby is the right size and your uterus is enlarged, I would try to remain hopeful, but also decide what action you'll take if your baby doesn't seem to be growing. I would also say they should not be doing vaginal exams since they are pretty useless, and can introduce an infection. It is a tough spot to be, and I don't envy it at all. My 2 miscarriages were "missed" for 3-4 weeks each time and I only knew once I started bleeding, and then went in for a first ultrasound to get more information about what to expect to have come out. I am grateful I didn't know for 3 weeks, because I wouldn't have taken the drugs anyways (or wouldn't have wanted to).


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## livysmom2013 (Jan 18, 2014)

After going through this for the second time, I agree that a routine ultrasound shouldn't be done so early. Although, maybe it is best because now I can prepare myself. The next day they sent me to get another abdominal ultrasound on a full bladder, with better equipment, and a vaginal ultrasound as well. The day after that the dr called to inform me that they still did not see a heartbeat and the embryo measured about 8 weeks . They took another blood sample to test my hcg levels and I will get those results tomorrow. But from what I understand, hcg levels begin to decline after 8-12 weeks in a perfectly healthy pregnancy, so I am confused at how this is an accurate indicator of miscarriage either. Either way I plan to wait it out to see if things happen naturally. I do not want to go through a medically induced miscarriage again as it was extremely painful. I also do not want a d&c as I do not want to go through surgery. I also want no doubt that the baby is not alive before I do anything this time. I just do not know how long I can wait it out naturally without risking infection. But you say your missed miscarriages were missed for 3-4 weeks? I suppose I can assume I can wait at least that long I hope.


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## Margo B (Oct 4, 2012)

Yes, I'll look for the studies/sources I found before, but from what I understand the risk of infection is really more theoretical than proven, since they haven't really studied it, as most people opt for medical management or a D & C. I think the body should get the signal once the progesterone drops low enough or the hcg drops low enough, which is why it does usually take a few weeks if left alone (that is what used to be normal before they started intervening so much). So the embryo measured 2 weeks different from one day to the next? Sounds like the first person was doing a bad job (or someone was?). Feel free to PM me if you need support! I hope my post didn't come off as snippy/judgey, I just get so frustrated about the way that technology has made everything so much more complicated for us  As if it isn't hard enough to lose a baby, or to be pregnant after a loss! <3 Keep us posted, and I will be curious to hear how it all turns out for you. Hoping everything is fine, and that you will get some confirmation of that soon!!!


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## livysmom2013 (Jan 18, 2014)

That makes a lot of sense about the body miscarrying as soon as the hormone levels drop low enough. I hope and pray that is what happens for me....You did not come off as snippy/judgey at all. I appreciate you sharing your thoughts and experiences with me. That is why I posted here So the first ultrasound I had in the office the nurse said it looked to be about 8 weeks, the next ultrasound done by the ultrasound technician revealed the same thing. I believe maybe you are referring to my first miscarriage where I should have been 8 weeks pregnant but the embryo measured about 6 weeks on all of the ultrasounds. So, so far I have two abdominal ultrasounds and one vaginal all measuring 8 weeks, with no heartbeat. Also I have gotten the results to one hcg test in which the dr said my levels were high enough that they should have seen something. I should be getting the results to my follow up hcg today....also, I forgot to mention that I had some spotting on Friday. It was only one time. There was a small amount of blood on the tissue when I used the restroom (sorry if that is tmi). So I just honestly wish something would happen already. The not knowing is what drives me nuts


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## Margo B (Oct 4, 2012)

So sorry to here that. Sounds like it probably is heading that way, but it must be so hard to not be sure, and to not want to give up hope if it does end up turning out for the best. What a crazy place to be emotionally  I hope you know one way or another soon. If you are going to have another miscarriage, and you had some spotting on Friday, it sounds like your body has started to realize. But if things are actually fine, spotting is obviously super normal. Anyways, I'm thinking of you and hoping for some resolution <3


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## livysmom2013 (Jan 18, 2014)

Thank you so much for your kind words. Yes it is very frustrating to be unsure, but I think today I just got my answer. My hcg levels are in fact dropping. They were 56,900 on the 7th and 2 days later they were at around 45,600. From how it was explained to me, it is normal for hcg levels to begin dropping between 8 and 12 weeks but they should make it a lot higher than 56,900 before they begin to drop. So I am about 99.9% sure I'm miscarrying and that is probably even being too hopeful. So I asked how long I can wait it out and they said 2 weeks. Does that seem fair to you? Or should I push to wait longer? I'm not sure I would want to go on longer than 2 weeks knowing that my baby is dead and not knowing when it's going to come out.







The thought of that is just very unpleasant and also not knowing when it could happen is stressful...I also plan on asking for one last in office ultrasound in 2 weeks before I proceed with anything. Just to be 100%.


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## Margo B (Oct 4, 2012)

I think that sounds like a reasonable approach! I don't mean to give you false hope because I know how annoying that can be in these situations, but to give you a comparison - I am 18 weeks pregnant now, and my hcg was 52649 at 9.6 weeks and 37897 at 11.6 weeks. It sounds like yours has dropped rather quickly so that might be another clue, but I doubt that mine ever got much higher than the 50-60,000 range which is well within the normal limits that I've seen. I'd say a repeat ultrasound would be a good idea if you aren't obviously in the miscarriage process before then. And if your levels are that high, it might take those two weeks before they drop low enough, unless your progesterone drops first you know? I would ask them what evience they are basing their 2 week limit on. Of course there are the emotions reasons for doing medical management, but I really haven't seen the evidence for not waiting as long as it takes. So sorry again. Such a tough spot to be <3


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## livysmom2013 (Jan 18, 2014)

That makes a lot of sense that the miscarriage would not actually start to happen until the hormone levels are low enough to tell my body that the pregnancy is over....That is very interesting that your hormone levels probably did not reach 100,000. The nurse that spoke with me said that they should at least get that high before dropping. You don't have to worry about giving me false hope because I am pretty certain at this point that I am going to miscarry and have already come to terms with it. I think the fact that there was no heartbeat seen on a vaginal ultrasound with an 8 week sized embryo was more telling that the dropping hormone levels. But the two combined, along with the minor spotting last Friday and my COMPLETE loss of pregnancy symptoms pretty much tells me it is over. The nurse did not give me any facts or evidence to base the 2 week limit on. She just said I would be risking infection. If I had one last ultrasound in 2 weeks and it still revealed an 8 week sized embryo with no heartbeat then I will be 100% positive that the pregnancy is not viable. And I think at that point I won't want to wait any longer for something to happen anyway. Actually because they had trouble getting me an appointment it will be closer to 3 weeks from now and about 4 weeks from the first ultrasound with no heartbeat. So as much as I don't want medical intervention I will be more than ready at that point to get this all over with. I am just not sure yet if the d&c or the medication is a better option (if it comes to that point). Thank so much for your advice and support! I will keep you posted if anything happens.


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## livysmom2013 (Jan 18, 2014)

So I went to the Dr. today and now I am confused about a completely different issue. I am now sure that I am having a miscarriage, however, I am not sure what happened with the embryo. When I went in 2 weeks ago for my initial visit, the nurse said she saw an 8 week embryo on the ultrasound screen and I saw it clearly as well. She just did not see the heartbeat. So today the Dr. did another abdominal ultrasound and saw a sac but nothing in it. He then did a vaginal ultrasound and saw an 8 week sac but just a small amount of tissue that he said was too small to even measure and referred to it as a "blighted ovum. or maybe the embryo began to develop. It is really hard to tell" . I thought that a blighted ovum was where a sac develops but no baby develops inside it? It was pretty clear to me that the tissue inside the sac today was smaller than the first ultrasound a couple weeks ago. Is it possible that the embryo is already beginning to break down but none of it has come out yet? I have only had some minor spotting for the past few days. No clots or anything. I am so confused. Was there ever a baby there or not?


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## Margo B (Oct 4, 2012)

Yes, the baby can either start to "break down". I've heard of people having the whole baby, sac, and placenta be "reabsorbed" which to me means it broke down, and didn't come out in any discernable fashion, just with the flow of the next bleed. So sorry that it is going that way. If you pass everything naturally, you would likely just see the sac (which would be a decent size, they could tell you exactly but maybe 2.5 to 3 cm in diameter?) and wouldn't be able to make out the baby inside, unless the ultrasound just was wrong, which is possible too. They were able to measure a 6 week embryo about a hour before I passed it, and I couldn't see it inside. I did see my 7 week baby though, even though it had started to break down slightly. What did you decide with moving forward? Still waiting?


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## livysmom2013 (Jan 18, 2014)

Well I had an appointment for a d&c set for next wed morning but I may very well end up canceling it. I was getting impatient but now that I am having a more steady flow, though very light like the end of a period, I at least am seeing something consistent. At this point I feel it would be unnecessary to go through a d&c when it seems my body is already taking care of things on its own. Also I just spoke to a midwife who told me the same thing you just mentioned about it being possible to pass everything without it seeming much more than a normal period. I am actually glad that the embryo is beginning to breakdown because maybe that means it will be a little less drastic and more gradual when I pass everything(and hopefully less painful too)? I am not sure if that is how it works but I am hoping so. I am disappointed however, that it seems to be taking quite a bit longer this way. I really hope I do not see the baby. I think at this point it is breaking down so much that I won't....I am so sorry for what you have been through as well and appreciate having someone who has been though something very similar to myself to chat with about this.


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## Margo B (Oct 4, 2012)

Ya, I would avoid a D & C at almost all costs since you are already bleeding and since it is surgery, and has been connected to complications in future pregnancies, but that is just me. I've heard some people say it is no big deal, and others say it was much more difficult/serious than they had been led to believe it would be. You can always get one if you start bleeding too much, or if the process doesn't complete in the timeframe you want it too. Like you said, the drugs are another option too. I know one doc offered to send me home with a cytotec prescription in case I wanted it, which was nice. I didn't, but it isn't a bad idea to have it.


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## livysmom2013 (Jan 18, 2014)

That is what I was thinking. before I started bleeding I just wanted to do anything that would get this over with but now that I have a d&c scheduled, it seems like a bigger deal and I'm a bit scared to do it. It has been almost 3 weeks already but only about 3 or 4 days of light bleeding so I do wonder how much longer it could take. Hopefully it will all be over soon. I'd like to avoid the cytotec too if I can because the first time I took them it was pretty painful and with my daughter breastfeeding there is probably not much I can take for pain....I am just getting tired of waiting:-/


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## livysmom2013 (Jan 18, 2014)

Just want to give an update. As of last night I think it is finally over. I started cramping at about 6pm and by 9pm it was pretty bad. By 9:30 I began to bleed heavily/pass clots. Then by 10:30 I passed the sac. Sorry if that is tmi :-/.... It was actually much less painful than I expected and much much less painful that my first miscarriage with the cytotec. It was however more emotionally upsetting than I thought it would be. I am just relieved it is over. I am still cramping a bit and bleeding about like a normal period except that I am still passing some small clots. Once again sorry if that is tmi I am just wondering if it is all normal. I was also wondering how long to expect bleeding to continue?...I am going tomorrow to cancel my d&c and ask the Dr. what is next. I believe I will have to go get my hormone levels checked a few times until they return to normal. Anyway, I am sorry to you and to any woman who has had the misfortune of going through a miscarriage of any kind. What a horrible and cruel thing to have to go through Us ladies really have it rough sometimes


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## Margo B (Oct 4, 2012)

So sorry  It sounds like you did what you had to do though and I'm glad you could avoid the surgery and drugs this time around. Your doctor may want to do an ultrasound to be sure that all the tissue is out. It can vary a lot, but for me, both times I passes the sac, and then the placenta which was large enough to notice wasn't just blood. The first time I also passed a large clot with the membranes in it. So I would just say, don't be alarmed if you start cramping more heavily again, as that may mean there is still more to pass - just watch your bleeding as usual. Hopefully there isn't anything else though, and you're done with the physical part of it. I bled for 11 days after my 7 week miscarriage which was my second one (with 5 days of spotting before passing anything). I ovulated pretty quickly both times, I think on day 16 the first time and day 22 the second time, but it takes some people longer for that to even out so just be aware of that. I just peed on cheap pregnancy tests every few days to see when the hcg no longer registered, rather than getting blood drawn over and over. With the 7 week miscarriage I had a positive test on day 9 after passing everything, and a negative test on day 11, then ovulated on day 22, so it seems like the hcg has to be pretty much gone before your body starts a new cycle. That is all the physical stuff, but please feel free to private message me if you need someone to talk to about all the rest of it, which can really be so much harder in the long run. I was so grateful to connect with a few other mamas on here to talk after my experiences, and I always want to be available to do the same for others. Thinking of you and hoping that you are getting everything you might need to help you through this right now (lots of rest, good food, sympathetic friends) <3.


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