Missed miscarriage, better go with D&C, Cytotek(Misoprostol) or something else?

posted 3 weeks ago in TTC
Post # 2
2459 posts
Buzzing bee
  • Wedding: July 2018

Hi, I’m so sorry you’re going through this.  Something similar just happened to me in late September.  I’m 37 and was 8-9 weeks along, and the ultrasound showed that the fetus stopped developing at about 5.5 weeks.  I also wanted to move forward and not wait, so we scheduled a D&C for 5 days later (soonest my OB could do it).  I ended up having a natural miscarriage a couple days before the surgery.

I had a close friend who was going through the EXACT same thing at the same time – she’s also 37.  She opted for taking the medicine, and took several doses over several days with nothing happening.  She then decided to do a D&C.  She said it was really pretty easy and not painful. 

My impression is that the medicine (and a natural miscarriage) can be pretty painful with lots of cramping, and traumatic because you see everything passing.  Mine wasn’t painful at all, but seeing the tissue passing is definitely burned into my brain 🙁  I wish I could unsee that.  It didn’t literally look like a little baby or anything like that, thank god, but still.

In terms of just getting it over with and giving your body time to recover and hopefully TTC again soon, I thought the D&C was the best option unless your body does it first.

Post # 3
1862 posts
Buzzing bee
  • Wedding: July 2015

I have only had one miscarriage and eventually opted for a D&C.  In my mind, it went as well as such things can go.  The procedure only took about 15 minutes, had to wait in the hospital for an hour or so after.  Only had bleeding for about a day and a half, and no pain.  I got my period a month later and started trying again the following cycle.  I got pregnant that first cycle we tried afterward, and that was a successful pregnancy.  I delivered her full term vaginally, but was unable to deliver my placenta.  I had to have them manually remove it.  They said this could potentially have been due to scar tissue from the D&C, but also could have had nothing to do with it, so who knows.

Post # 4
110 posts
Blushing bee

If the pregnancy stopped progressing that early, then your body has very very little to get rid of.  I had several miscarriages in between my full term pregnancies and I chose to avoid the risk of scarring from a d&c procedure if it could at all be avoided.  I knew someone who got scarring and then had placenta accreta with her next pregnancy which she carried to term but when that placenta detached after delivery….it was a near death experience and they had to do an emergency hysterectomy.  That is rare but it weighed heavily on my mind.  I just did nothing after my miscarriages and let my body deal with it.  In fact, I miscarried once at about the same point as you and was frustrated that my body wasn’t dealing with it, I was expecting bleeding to start.  Then I began to feel sick and feverish and thought I might be getting infected and would have no choice but to get the d&c.  But it turned out I had conceived again without any bleeding in-between.  The thicker lining in there is what did the trick.  I carried that pregnancy to term.  I’m not trying to terrify anyone about d&C’s, despite how it may sound.  My mom had two and still had four healthy uncomplicated pregnancies.  But sometimes scarring can happen on the cervix too from where they insert the dilation rods.  I just didn’t want that risk, however small.  Please don’t feel discouraged by the miscarriage.  I had at least four that I know of (I stopped testing early when I got sick of the chemical pregnancy rollercoaster).  I have three healthy kids.  And every woman in my family who had children had miscarriages here and there in-between.  Sometimes the chromosomes in an embryo are just not good and nothing we do will change the outcome.  Misoprostol can be really painful.  Docs sometimes downplay how painful it is for some women.  Every woman decides differently.  Whatever you think is best for you.  But I would just say that you don’t need to bleed anything out really after such a short term pregnancy.  It’s just a matter of getting your cycle going again.  It’s like going off birth control.  It can take a while to get your period back on track but your body will sort it out.  There is no medical need to put your body through anything medically invasive or traumatic.  Patience is the safest route.

Post # 5
3801 posts
Honey bee

I’m so sorry you’re going through this. I have had ectopics and a chemical. The chemical naturally passed right around 7 weeks. It was like a bad period for a day, then more normal bleeding. I had surgery for the ectopics which was pretty painless. I have heard some unpleasant tales about using meds, so personally I would choose to wait for it to happen naturally or a D&C. 

Post # 6
613 posts
Busy bee

I had a D&C when this happened to me and I don’t regret it. It was pretty quick and painless, followed by a few days of period-like cramps, and then my regular period a month later. My doctors office was going to take forever to schedule it and advised that I would likely miscarry naturally before then so should look elsewhere — Planned Parenthood stepped into the rescue! It was as good an experience as these things can be. 

Post # 7
70 posts
Worker bee

So sorry for your loss.

im actually going thru the same thing right now so reading everyone’s responses help a lot.

on monday i had my second scan at 11 weeks 3 days and baby had died at 8 weeks 6 days. 

So my OB recomended medication Misoprostol, i had to insent 4 pills vaginally yesterday and 4 more today. So far it hasn’t worked… i have been cramping on and off and bleed a little bit yesterday but then stopped and it’s been 24h without any more bleeding which makes me think it isn’t working properly on me.

im terrified of doing a D&C for so many reasons so just praying things start to move along. 

I have very low pain tolerance and so far the cramps have been just like normal period nothing painful.

good luck to you 

Post # 8
421 posts
Helper bee
  • Wedding: November 2018

I started to have miscarriage symptoms at 9w and confirmed that the baby passed. I took misoprostol vaginally at first, but that didn’t work. One week later, I took misoprostol orally. Also didn’t work. I went with D&C in the end.

D&C was meant to be a day procedure but I had to stay at the hospital overnight because I lost a lot of blood, but it only happened because I had a huge fibroid. I was able to get chromosomal testing and found out that it was a baby girl with normal chromosomes. I needed that for closure. If I had to go through another miscarriage, I think I’ll opt for D&C to start.

So sorry for your loss.

Post # 9
66 posts
Worker bee
  • Wedding: December 2019

I am SO sorry for your loss.  I have miscarried both ways.  I had a missed miscarriage when I should have been 12 weeks along (baby stopped growing at 9w5d).  First my RE wanted me to wait it out and see if I would miscarry naturally.  It did not happen.  I waited for over 2 weeks and emotionally it was killing me.  I went in for another ultrasound while my RE was on vacation, and my OB stepped in (they are in the same practice), and asked if I wanted to get it over with and get a D&C.  She was much more concerned about my emotional wellbeing at that point, which I truly appreciated.

The D&C went very well and I had a smooth recovery.  I wish I had done that for my second miscarriage.  With the second one I tried misoprotol and it was awful.  I missed more work than I did with the D&C (just one day for D&C – 3 for the misoprostol), and I had huge clots.  I ended up having to call my RE’s office because of the clots, heavy bleeding, and pain.  It just made things harder for me.  I am not trying to scare you, because that is not everyone’s experience, but if I could have done it over, I would have done a second D&C.

Post # 10
1299 posts
Bumble bee
  • Wedding: June 2016

I had a MMC at 6 weeks and by 12 weeks still no sign of my body handling it naturally. At that point my doctor was beginning to worry about infection so I opted for a D&C for a couple reasons:

1. Work was busy and I didn’t want to have to deal with not knowing *when* the medication would take effect or be really out of commission and in pain for a couple days

2. I wanted to get things done as quickly as possible so I could start trying again – I didn’t want the risk of left over tissue, etc

I had the D&C on a thursday late morning, took the afternoon off. Worked lightly from home Friday afternoon (joined some calls but that was it) and by Monday was back to full steam. I had no cramping or pain post D&C, just fatigue so I slept a lot and had to physically take it easy as I tired very easily (even going up or down a flight of stairs winded me and I’d have to sit and rest for the first 24 hours. I’m very active and fit so that was a bit of a shock – but by ~48 hrs I felt pretty normal and by 72 hrs felt back to normal energy levels.

Post # 11
4995 posts
Honey bee
  • Wedding: January 2017

Having had gone all 3 ways, naturally, miso and with a d&c I have to say d&c all the way!!! Got up after it and just had minimal spotting, no downtime, no waiting forever for the bleeding and clotting to stop. At 11 weeks I would be scared of having retained tissue after going w a natural miscarriage and then having to get a d&c anyway later. Misoprostol still left tissue for me.if you want to TTC asap then d&c is the way to go. 

Post # 12
174 posts
Blushing bee
  • Wedding: April 2016

sunnyorchid :  For my first two MMC’S, I opted to do D&Cs and I regret it. At the time I thought it was a great option as it was less emotionally and physically taxing. However, I ended up with scarring from the procedure and had to have it surgically removed. It was an emotional process for me. My 3rd MMC I refused a D&C and took miso. It wasn’t too painful but it was hard to have to pass the tissue at home on my own, but I was not willing to take any more risks. When I finally had a successful pregnancy, I had an extraordinarily sticky placenta and had removal complications, which *could* have been caused by previous procedures but no way to tell. My OB told me that I am now at risk for placenta accreta for my next pregnancy, which can lead to emergency hysterectomies. IMO D&Cs are not worth the risk, although I know many people that had successful ones without any complications. 

Post # 13
303 posts
Helper bee
  • Wedding: June 2014

I had a d&c for my missed miscarriage.  I hadn’t had any kind of bleeding or cramping at all and only found out I had miscarried during an ultrasound appointment.  I was able to get it done the next day. Honestly the idea of waiting for it to happen was too much for me emotionally.  The procedure itself was not bad at as ll. I had general anesthesia and it was an outpatient procedure.  I had it done on a Friday and was back to work Monday.  I had minimal pain following so the recovery was not bad.  The hardest part was the emotional aspect for me.  I got pregnant again 8 months later and never had any issues with conception or pregnancy afterwards.  Good luck with whatever you decide. Hugs!

Post # 15
9586 posts
Buzzing Beekeeper
  • Wedding: August 2012

I have done both and would do the D&C.

I didn’t actually have much pain with the pills, but the bleeding was pretty extreme and hard to deal with. It took 3 months for my period to come back and when it did (TMI warning here) I passed a huge chunk of what I can only assume was leftover placenta. So obviously the meds did not work completely.

The D&C was simple, in and out, one day off work with minimal bleeding afterwards.

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