Friday, September 26, 2014

Waiting Until 10 Weeks for a D&C. Is it safe?

Let me just state right up front, I'm not a doctor or medical professional.  In fact, the only 'medical' training I have had was in the Army (yes, I'm a former soldier) who took a combat lifesaver course.  That training involved IVs and what to do if somebody is hit with a grenade....just a little different than this.  I like to state this up front because when I do share 'recommendations', they are recommendations found elsewhere online by trusted sources.

Often, when women are not sure they are really going to miscarry or not, they wonder if it is safe to wait out a diagnosis.  I know my own doctor, as early as six weeks, was putting the scare of future infertility and massive infections into my head.  However, I was really uneasy with the idea of a D&C and I am so glad I was because I now have that little girl who is just a light in my life.

So, is it dangerous to wait out a diagnosis?  I would say no under a few conditions:
  • As long as you are staying under a physician's care and will be seen right away if there are complications (i.e. fever, signs of infection, pain, etc...)
  • Your physician agrees (and, yes, sometimes you may need a second opinion)
  • Your physician has ruled out an ectopic pregnancy 
 And here is where I want to pull out the 'trusted source', in this case the American Pregnancy Association.  On their  D&C Procedure After a Miscarriage page, they have this to say:
"About 50% of women who miscarry do not undergo a D&C procedure. Women can safely miscarry on their own, with few problems in pregnancies that end before 10 weeks. After 10 weeks, the miscarriage is more likely to be incomplete, requiring a D&C procedure to be performed. Choosing whether to miscarry naturally (called expectant management) or to have a D&C procedure is often a personal choice, best decided after talking with your health care provider."
 Without a doubt, D&Cs have their place.  I've seen on The Misdiagnosed Miscarriage that often after ten weeks, women end up in the ER or just needing to schedule the procedure because the miscarriage just won't start.

If you are not yet ten weeks and feeling pressured to end your pregnancy, is there a valid reason?  The very vague 'you don't want an infection' reason isn't a great one.  With all the woman I've talked to over the years, only a small percentage have mentioned getting an infection.  If you are staying monitored and watching for complications, asking to wait out a diagnosis is generally accepted by most doctors and, if you feel your doctor is pressuring you too soon, seek a second opinion.

As always (((hugs))) to anybody going through this scare.

Saturday, September 13, 2014

Tilted Uterus and Miscarrying? You Might Want to Skip the Medicated Miscarriage and Here's Why

I like to stay on top of recent first trimester research.  I keep hoping that one day somebody will listen and do a study on the tilted uterus during the first trimester.  We already know on The Misdiagnosed Miscarriage what they'll find.  Women who have a tilted uterus often look one to two weeks behind during the first trimester and are too often misdiagnosed with a miscarriage as a result.

So, it was with some interest I took a look at this study:

Efficacy of misoprostol in relation to uterine position in the treatment of early pregnancy failure

Turns out there may be another problem if you have a tilted uterus.  A medicated miscarriage (where you are given drugs to help along the miscarriage) does not work well with women who have a retroverted uterus. 

I believe this.

Over the years I have had too many women share their 'horror' stories with Misoprostol (Cytotec).  Other women have said, "Aww, it wasn't too bad."   Well, we know that roughly 1/3 of women have a tilted uterus.  We also know that research really indicates that after 8 weeks, a woman with a medicated miscarriage is much more likely to end up with complications.  That rules out a lot of women who should even consider a medicated miscarriage.

I wrote more on this topic here:

Tilted Uterus? If You Are Miscarrying, You May Want to Skip The Medicated Miscarriage.

May want to skip a medicated miscarriage if you:

  • are eight weeks or more along
  • have had any prior uterine surgery including c-section
  • are anemic
  • have a tilted uterus
  • have any sort of stomach or intestinal disease
  • have had five or more births
If your doctor is recommending a medicated miscarriage, please find out if you have a tilted uterus first. 

As always, (((hugs))) to you if you are going through a miscarriage scare right now

Sunday, September 7, 2014

Stories of Women Who Turned Down a D&C due to Blighted Ovum and Found their Babies!

Today I want to share with you a few very important stories.  Each of these stories can be found on the Misdiagnosed Miscarriage site. While not all of these were found at nine weeks or beyond, you can see that they were diagnosed too early.  As I've said over and over, I love the new guidelines that state a doctor should wait until the gestational sac is 25mm and then wait one week more to verify.  That would put women at about nine or so weeks which would prevent so many misdiagnosed miscarriages!

Amanda's Story
Diagnosed with a blighted ovum and encouraged to have a D&C. When she called to schedule the procedure, they decided on one last ultrasound.
Tera's Story
At eight weeks, there was still no baby to be seen in that sac. Tera went home to wait for a miscarriage that never happened. The next week, they found her baby!
Angie's Story
At about seven and a half weeks, there was still no baby seen and the doctor did not like the slow-rising hCGs so she recommended a D&C. Fortunately, Angie declined and decided to seek a second opinion. One week later, they found that little heartbeat!
Dani's Story
Told she had a blighted ovum at eight weeks, she was encouraged to have the D&C. Two weeks later, Dani had another ultrasound and there was her baby!
Es's Story
Es was diagnosed in the ER at eight weeks and told to have a D&C, thanks to the Misdiagnosed Miscarriage site, she decided to wait two weeks at which time they found the baby with a strong heartbeat.
Sarah's Story
At seven weeks four days, Sarah was told she had a blighted ovum. She decided to wait out the diagnosis rather than have the D&C. At nine weeks four days, they found her baby!
Kelli's Story
At only six weeks, Kelli's doctor was concerned about her higher hCG levels and no baby. She turned dow the D&C. Kelli waited and then sought a second opinion where they found that little heart beating away.
MommyToBe's Story
At ten weeks, they were unable to find her baby. She turned down a medicated miscarriage. A week later, they found her baby.
Sher's Story
At seven weeks, Sher's doctor scheduled a D&C for her. Thanks to the many online stories, she decided to cancel the procedure. Thankfully they found their baby the next week.

High hCG and No Baby Found? There is Still Hope and Here are the Stories to Prove It!

These are just a few of the stories from women who have had ultrasound levels between 10,000 and 20,000 with an empty gestational sac. Many times they were told they were going to miscarry or that they needed a D&C and they ended up finding their babies! Because there are so many stories, I am only including a few in this category. Rest assured, if your levels are between 10,000 to 20,000, there is still hope! Of course there is no way to tell how the pregnancy will end but, unless you are certain you are nine weeks or more, it is much too early to diagnose a blighted ovum at this point.

please remember, none of these stories will change the ultimate outcome of your pregnancy. These stories, however, will help you to know if you are possibly being diagnosed too soon.
Angel's Numbers
Empty Sac: 18,875 (with ultrasound)
Five Days Later: 51,266 (no ultrasound)
Heartbeat Found: 9 Days after empty sac ultrasound
Tao's Numbers
Only Yolk Sac seen: 12,954 (with ultrasound)
Two Days Later: 17,095 (no ultrasound) ~ D&C refused
Heartbeat Found: 13 Days after ultrasound
ShelBelle's Numbers
Empty Sac: 19,000 (with ultrasound)
Two Days Later: 26,500 (no ultrasound)
Heartbeat Found: 12 Days later
Christy's Numbers
Only Yolk Sac Seen: 19,000 (with ultrasound) ~ scheduled D&C
Heartbeat Found: 3 Days later
SwollaDad's Numbers
Empty Sac: 13,000 (with ultrasound)
Two Days Later: 25,000 (diagnosed ectopic!) ~ injection to end pregnancy refused
Heartbeat Found: One week + after initial ultrasound
BelievingGod's Numbers
Empty Sac: 23,000 (with ultrasound)
Four Days Later: 33,000 (no ultrasound) ~ D&C scheduled
Heartbeat Found: 13 Days after initial ultrasound
Eprooso's Numbers
Empty Sac: 11,000 (with ultrasound) ~ D&C recommended
Three Days Later: 29,000 (no ultrasound) ~ D&C recommended
Heartbeat Found: 10 Days after initial ultrasound
Jen's Numbers
Empty Sac: 11,000 (with ultrasound)
Six Days Later: another empty sac ultrasound ~ D&C recommended
Heartbeat Found: 13 Days after initial ultrasound
Carly's Numbers
Empty Sac: 19,000 (with ultrasound)
Later that Week: Had a D&C
The Week after the D&C: Baby survived D&C (that baby was born in March 2010)
Otis86's Numbers
Only Yolk Sac Seen: 14,900 (with ultrasound) ~ D&C recommended and refused
Heartbeat Found: Several days after initial ultrasound
Lltruc's Numbers
Empty Sac: 11,000 (with ultrasound)
Two Days Later: 16,500 (no ultrasound) ~ medication to begin miscarriage refused
Heartbeat Found: 7 days after initial ultrasound
Heartbeat Found: Several days after initial ultrasound
Tania's Numbers
Empty Sac: over 9,000 (with ultrasound) ~ D&C refused
Three Days Later: 36,000 (no ultrasound) ~ D&C refused again
Heartbeat Found: 9 days after initial ultrasound
 Over the years, I've talked to quite a few women who had empty-looking sacs with levels over 20,000. Having a doctor say there might still be hope at this point is a very rare thing and, yet, quite a few women go on to find their babies. Again, these are only a few of the many stories we've collected. If you are not more than nine weeks yet, even with higher levels, it is still too soon to know if this is truly a blighted ovum.

Jen's Numbers
Empty Sac: 30,000 (with ultrasound)
Four Days Later: 50,000 (no ultrasound)
Heartbeat Found: 12 Days after empty sac ultrasound
BelieveNPrayer's Numbers
Empty Sac: 32,000 (with ultrasound)
Two Days Later: 45,000 (no ultrasound)
Four Days after Initial Ultrasound: 42,000 (no ultrasound) ~ D&C recommended
Ten Days after Initial Ultrasound: 110,000 (no ultrasound)
Heartbeat Found: 15 Days after empty sac ultrasound
Lori's Numbers
Empty Sac: 11,000+ (with ultrasound)
Another Empty Sac: 3 Days later with hCG levels 27,000+
Heartbeat Found: 11 Days after initial ultrasound
Ally's Numbers
Empty Sac: 38,000 (with ultrasound) ~ refused D&C
Heartbeat Found: 5 Days later
Prayin4You's Numbers
Empty Sac: 25,000 (with ultrasound)
Six Days Later: 38,000 (with ultrasound)
Heartbeat Found: 18 Days after initial ultrasound
Sarah's Numbers
Empty Sac: 16,000 (with ultrasound)
Three Days Later: 24,800 (with ultrasound) ~ refused D&C
Seven Days after Initial Ultrasound: 34,000
Heartbeat Found: 14 Days after initial ultrasound
Sadie's Numbers
Empty Sac: 44,000 (with ultrasound)
Heartbeat Found: 2 Days later
Steph's Story
Empty Sac: 12,000 (with ultrasound)
Three Days Later: 45,000
Second Empty Sac: 7 days after initial ultrasound ~ D&C refused
Heartbeat Found: 14 Days after initial ultrasound
Autumn's Story
Empty Sac: 28,000 (with ultrasound)
Heartbeat Found: 13 Days after initial ultrasound
AspenMommy's Numbers
Empty Sac: 32,000 (with ultrasound)
Heartbeat Found: 2 Days after initial ultrasound
LinBran's Numbers
Only Yolk Sac Seen: 20,000 (with ultrasound) ~ D&C scheduled
Heartbeat Found: 3 Days after initial ultrasound right before scheduled D&C
Ozlem's Numbers
Empty Sac: 22,900 (with ultrasound)
Two Days Later: 32,000 (no ultrasound)
Heartbeat Found: 7 Days after initial ultrasound

These stories are truly amazing because doctors are always certain miscarriage is imminent when levels are over 50,000 and no baby is seen. These stories show that some babies just hide a bit longer and a D&C should not be rushed!
Kim's Numbers
Empty Sac: 66,000 (with ultrasound)
Heartbeat Found: 2 Days later with hCG levels at 90,000
Peanut's Numbers
Empty Sac: 69,000 (with ultrasound)
Five Days Later: 74,000 (no ultrasound) ~ scheduled D&C
Heartbeat Found: 7 Days after initial ultrasound
Katrina's Numbers
Empty Sac: 87,000 (with ultrasound)
Heartbeat Found: 7 Days later with hCG levels at 147,000
GoneToExplore's Numbers
Empty Sac: 52,000 (with ultrasound)
Heartbeat Found: 3 Days later
Tera's Numbers
Empty Sac: 80,000 (with ultrasound)
Two Days Later: 76,000 (no ultrasound)
Heartbeat Found: approximately one week after the initial ultrasound
Ginger's Numbers
Empty Sac: 56,000 (with ultrasound)
Two Days Later: 71,000 (no ultrasound)
Five Days after Initial Ultrasound: 106,000 (no ultrasound)
Heartbeat Found: 6 Days after initial ultrasound
These are only a few of the stories on The Misdiagnosed Miscarriage site.  My hope is that these give you hope.

Because so many women are fixated on hCG numbers (you really shouldn't be), please, check out my blog post:

High hCG and No Baby Seen? FORGET THE hCG! It's All About the Size of the Gestational Sac!

Enlarged Yolk Sac? Yes, You Still Have Hope!

Over the years, I've written pages on various misdiagnosed miscarriage topics.  One of my more-read pages has to do with enlarged yolk sacs.  Because I've had to move the page (sadly the host closed its doors), I have to find a place to share these links and here is as good a place as any.

The takeaway from these stories is that a diagnosis of an enlarged yolk sac does not doom your pregnancy.  Here are the links to some women who continued on in their pregnancies:

One of my hopes by sharing these stories and links is that women who know of other stories or have their own success story will share them here as well.  These are only a few of the stories I've read but, if you've been told there is no hope, these stories will prove your doctor wrong.

Story A:
Stacy was sent home to miscarry by her doctor because her yolk sac was enlarged. Her yolk sac grew to 9mm. Her baby was born perfectly healthy.
Read  Stacy's story,

Story B:
Tulip was measuring about a week behind and the yolk sac measured 9.2mm. She went on to have her beautiful baby.
Read Tulip's story,

Story C:
Tara had a yolk sac measuring 8mm. She's just recently had her 20-week ultrasound and everything looks wonderful!
Read  Tara's story,

Story D:
One concerned husband reported that the yolk sac during his wife's pregnancy measured 8.2mm. They went on to have a healthy baby girl.
Read his story,

Case Study:
Very Large Yolk Sac and Bicornuate Uterus in a Live Birth A case report in which a yolk sac was measured at 8.1mm but resulted in a live birth. This report states that "the quality of the yolk sac might be more important than its size."

Also, if you'll find I've blogged a on the unreliability of ultrasound measurements.  It may just be that your tech was off.  It happens more frequently than you think.

If you end up being diagnosed with an enlarged yolk sac and find out all is well, could you consider sharing your story  at the Misdiagnosed Miscarriage site.  You'll give other women hope. 

Thank you!