# Missed miscarriage at 9 weeks (development stopped at 6 weeks) - D&C or cytotec?



## skj2011 (Jul 19, 2011)

Hi Ladies,

I found out on Friday that I lost my baby two weeks ago (I was 8+ weeks, baby stopped developing at 6 weeks). I had originally decided on doing a D&C to just move things along, but after having some time to read about it, I'm not sure what to do.

It took us a while to conceive this baby (10 cycles) and I don't want to do anything to risk impeding future efforts. I'm trying to weight my options. If you have any info to help me make this decision, that would be really helpful. Here is my current internal battle:

Pros of D&C


Over quickly
According to my acupuncturist, I can TTC as soon as my period returns, which is likely to be 4-6 weeks
My acupuncturist also said that a D&C can be helpful to remove stuff that could have been interfering with conceiving.

Cons of D&C


Asherman's syndrome. My midwife told me this risk was really small and only really affected people who have multiple D&Cs, but my research revealed a risk of between 7.7% - 30+%!!! This is the one that really freaks me out.
Other risks of surgery/anesthesia

Pros of Cytotec/Medical method


More "natural" in my mind
No added risk of impeding future fertility Is this true?

Cons of Cytotec/Medical method


Risk of bleeding 
May need D&C anyway
Pain!

I also have some questions about taking cytotec:


How long does it take for your cycle to return, typically?
Is there any reason to not TTC immediately after my cycle returns. 

I'm so conflicted on what to do. I just wish I had a crystal ball.

Thanks!

S


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## brambleberry (Oct 20, 2011)

That issue with Asherman's syndrome has been worrying me too. From what I could tell (and I could be wrong), it's just one study that showed that high risk potential. A few different websites referred to it, but still just one study. I couldn't find any other studies that said anything about risk of Asherman's specifically for D&C's for miscarriage, but most sites I saw said overall risk was 1% or less. I ran that by two different doctors, and they were both very skeptical of the risks being anywhere near that high - they rarely see any cases of Asherman's, and plenty of women in their care have D&C's. My family doctor pointed out that the study probably wasn't looking at clinically significant cases of Asherman's - it sounds like they are checking for adhesions with an endoscope and the slightest little trace of one is included as a case of Asherman's, even if it's too insignificant to ever cause any problems. My other doctor is recently out of OB training, and he just flat out dismissed that study and said the risks were minuscule.

I still felt enough worry about the risk of Asherman's to wait to miscarry naturally, but it's been almost 3 weeks now from the time my baby died, and I'm being encouraged to choose cytotec or D&C due to the risk of infection after 3 weeks. So I've finally chosen D&C - I'm going in for it tomorrow morning actually. I felt like the risk of hemorrhage with cytotec was too high, compared to the risks of D&C (if you throw out that one study), and I absolutely don't want to end up with an emergency D&C. I just don't need that kind of drama right now. So that was my decision, but I'm not saying it's the best one. I still feel discontented with the lack of solid, straight-forward information out there. Miscarriage is just such miserable business.

I'm sorry you're having to go through this, too. I'll be thinking of you.


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## skj2011 (Jul 19, 2011)

Thank you so so much for your reply! I'm so sorry you are in a similar place.

What you said made a lot of sense. The other thing my acupuncturist mentioned was that I don't have a history of fibroids or other conditions that would pre-dispose me to ashermans. I'm thinking I'll likely also have a D&C, perhaps tomorrow too.

Good luck. I will be thinking of you.

((HUGS))


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## carmen358 (Jul 5, 2008)

I just saw your name here SKJ. I don't know if you remember me from ttc while nursing. I'm so sorry for your loss









I just opted for meds to start my m/c....it was taking weeks and I was afraid of infection. I too would wait as long as possible being having a D&C if you can.

Big hugs...I hope things work out for you.


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## skj2011 (Jul 19, 2011)

Hi Carmen. I do remember you. I'm sorry to "see" you here.







I actually just replied to your post about the bleeding.

I had my D&C this am. It was a awfully tough decision and I think I made the right one, but I really, really didn't want to have to make it.

I guess only time will tell if I made it through without fertility complications.


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## DawningSun (Sep 13, 2011)

I'm sorry you are going through this awful situation. I too found out on Friday that my baby had died, I was 18 weeks pregnant. I opted for cytotec (after much questioning and soul searching.) For me I let the OB know how very cautious I wanted to be with the medication. I suggest taking 300Micrograms to start and 300 micro grams the second dose about 4 or 5 hours later. And continuing on this way. For me that is what I did I totaled 800micro grams altogether (typically 800micrograms would be the second dose!) and I delivered my baby boy 7 hours later. Barely any pain, mild discomfort (for me) and an extremely smooth delivery of baby and placenta, barely any bleeding at all. It's an awful decision to make, truly. I believe birthing the baby in a gentle way can be very rewarding even under such awful circumstances. And remember you do not have to take the cookie cutter route you can tweak the dosage with you OB. They should be responsive, if not than you need to find someone who is. I was lucky to have an OB who listened and respected my wishes for a minimal medication dose. I feel very content with my choice.


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## M Anna (May 27, 2011)

Ladies, I am so sorry for all of your losses. These are circumstances under which I hate to meet any of you.

I had two missed miscarriages last year, both with the baby aged 13 weeks. I opted to wait out the first one and he was born about 2 1/2 weeks later. Took two hours start to finish, minimal pain, "ordinary" amount of bleeding, nothing retained. I started AF 29 days later. I decided to do cytotec with the second because it was getting close to Christmas and I didn't want to risk miscarrying Christmas eve or something. I was induced in the hospital. It was much longer, about 9 - 10 hours, very painful the last two hours and I lost a lot of blood. The pain was largely due to the balloon catheter they placed in the cervix to help it dilate. I do not recommend that. I also retained half the placenta but they were able to remove it at the bedside (not comfortable) instead of taking me for a D&C. I started AF 35 days later. I would have waited and not done the cytotec but for the reason I stated. I think it was better when I let my body get ready and start on its own instead of "forcing it". For the record, my second baby was born 13 days after he died, so it wasn't like I had it the next day. We were hoping things would start on their own but they didn't.

I have a site about miscarriage and I have an information page comparing the various methods: natural, cytotec, D&C, etc. I was desperate for information when I lost my first baby and after that I decided there needed to be more information out there that wasn't fuzzy or with a lot of details left out. I wanted to know the gory details, so to speak, because I wanted to know exactly what to expect. If it would help anyone, here is the link. (The birth stories are there too amongst others and also photographs on a separate page.)

I wish all of you healing.


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