Friday, July 3, 2015

Is a D&C Necessary When You've Been Told You are Going to Miscarry?

It's the first trimester and you've been told you are going to miscarry.  Your doctor is telling you that you need to have a D&C as soon as possible and you are wondering if it is really necessary.

First things first, are you certain you are miscarrying?  Why is your doctor so sure you are miscarrying?  Is it because there is an empty sac?  If so, my first question is whether or not your gestational sac is growing and if it is more that 25mm (see New Blighted Ovum Guidelines! Chances Are You ARE Being Diagnosed Too Soon!).

If there are serious complications, ending your pregnancy right away may be necessary (i.e. infection setting in, ectopic, molar pregnancy, etc...).  If your doctor does believe there is a serious complication but you are not convinced, you may decide to seek a second opinion but, please, do it right away.

Serious complications aside, do you need to have the D&C right away?  Let's see what the American Pregnancy Association says:

"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."
Please take note:
"Women can safely miscarry on their own, with few problems in pregnancies that end before 10 weeks."
The takeaway is this:  If you are not 100% certain of your miscarriage diagnosis and there are no complications -or- even if you are certain and would prefer to miscarry on your own, waiting for a natural miscarriage is an option many women choose.   You should not feel pressured to have a D&C if you do not want one.  You can always choose to have the D&C at a later point.  You should not feel rushed.

After ten weeks, miscarriages may become more complicated and a D&C may be the safest way to go.  Talk to your doctor and the two of you can determine your best course of treatment.

As always, seek a second opinion if you are at concerned that your diagnosis might not be an accurate one.  This isn't false hope.  This is just being 100% certain before you end your pregnancy.

17 comments:

  1. Hi my last menses was on 23 May, on 10 July vscan saw an empty sac measuring 19.4mm. I have been having morning sickness. My hcg was measured 32457. On 20 July, another V scan was done ges sac still empty measuring 24.6mm and My hcg lvl is 64257. Was told to scan again on 27 jul. I had a chemical pregnancy in Feb. Waited 3 months b4 trying again. Yet I Am now faced with this.

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    1. Hi Brittany. I replied to your email. (((hugs)))

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  3. LMP measures me at 8w6d but got my first ultra sound today which measures me at 6 weeks and tech seen yolk sac but no baby . I'm so confused. I have another ultrasound scheduled next week because my levels are progressing . My last hcg check was 106,321

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    1. Hi Keshia. I am so sorry you are going through this scare. Many women look one to two weeks behind so that is not really concerning. The best thing you can do if there are no complications is wait a week to see if more can be seen. If the sac is growing, it should measure more than 25mm before a miscarriage is diagnosed. (((hugs))) and keep us updated.

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  4. Hi!
    I have read forum after forum, and I am still confused about my recent ultrasounds. 
    According to my LMP(September 9) I am 9 weeks and 5 days. But, I have 32 days cycles and I ovulated September 25th or 26th. I think that makes me earlier that what my LMP reveals. 
    I had my first ultrasound on Thursday, November 5. The gestational sac and yolk sac were present, but no fetal pole. I went back Monday, November 9, and the fetal pole was present, but heartbeat was faint, but it was there....an amazing little flicker! 
    I had a third ultrasound Friday, November 13th. The heartbeat was not seen, and now TWO yolk sacs appear in one gestational sac. 
    The doctor suggested that I schedule a d&c for tomorrow, Monday. But he assured me that they would do another ultrasound right before so I would be sure. No one ever called me to schedule. 
    So, I have decided to get a second opinion. I do trust my doctor, but three ultrasounds and three different reports? I don't want to have false hope, but I want to be sure before any decisions are made. I just wondered if anyone else has had anything similar happen and what was the outcome? Any advice? I have had two healthy pregnancies. Also, I have only had bloodwork done once, and my HCG and progesterone were within the normal levels. 
    Thank you!

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    1. I think a second opinion is always a good idea in cases like this and make sure your ultrasounds are a week apart (if there are no complications)

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  5. Can someone help me with this, for my gestational sac: 3.4 cm
    crown rump length: 2.1 cm
    Yolk sac: 6.6 mm
    with no heartbeat. I'm scared, should I be worried
    Is this normal at 8 weeks 5 days.

    Now as of today I am 9 weeks and 3 days. I already did some blood work on my hcg levels. Won't know the results until Tuesday

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    1. Normally, a week after the baby is seen without a heartbeat, they'll do a follow-up to verify. Sometimes it was still just too small to be seen. (((hugs)))

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  6. Kay Suzanne, I had an u/s at what I thought was 8 weeks 2 days and was told baby measured at 5 weeks 6 days, heartbeat was seen and was 88. Went today 2 weeks later for u/s and they said I'm measuring at 3.6mm and about 7 weeks and no heartbeat was seen. They told me I'm having a miscarriage but I just don't know. I've had no bleeding, spotting or cramping. Not sure what to think right now. My name is Tisha Burchett. Not sure how to use this sight.

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    1. What was the turn out of ur situation? I'm going thru this right now.

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  7. Hello,
    I had transvaginal u/s may 3rd which would have been 8 weeks past lmp. Dr said she did not see heartbeat and was measuring baby at 7 weeks 4 days. She told me i miscarried and should arrange for d&c. If I was off on calculation would you 100% see a heartbeat?? I am also taking bisoprolol a drug that lowers blood pressure and heart rate. I wonder if this could effect the reading??

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    1. If there are no complications, you should ask for another ultrasound to verify. (((hugs)))

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  8. Hi I'm 6wks and 3 days along and after my first vaginal sonogram I was told that there was no heartbeat and I have low HCG levels so I'm more than likely going to have a miscarriage is this accurate or should I get another opinion... I also have alot of menstrual like cramps what are your thoughts?

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    1. You are so early that it is tough to know what is happening. They should do another hCG check to see if your levels are rising. If they are and there are no complications, another ultrasound a week out should tell you if the sac is growing and if there is still hope. Stay closely monitored and be seen right away if there are complications. (((hugs)))

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  9. Hello,

    I had a little bit of bleeding a couple weeks ago at around what should be close to 8 weeks based on a 28 day cycle. I went to the ER, and the doctor said spotting is normal. He sent me for a vaginal ultrasound just to make sure. When the results came back he told me that unfortunately I had a missed miscarriage. My results showed baby measure 6wk6d and no heartbeat with HCG at 100,000+. He spoke about a D&C and medication to help process. My husband and I were heartbroken. The next day I went to a new OB and she looked at the results and immediately asked me if my cycles were exactly 28 days. I explained to her they varies sometimes were longer. She said she was hopeful that I may just be off and that I am not as far along as we think. She sent me for blood work and scheduled and another vus. The next week I went in for the US and that doctor told me there wasn't a heartbeat and that my baby measures 5wks! Needless to say we are very worried and not hopeful at all now. My OB also called and told me my HGC levels were at 75,000 after 4 days from the first blood test at hosptital. She is sending me for one not Us this week to confirm everything. Reading your site has made me hopeful for a miracle, but more than anything it has been great to learn about all these different things. I have two healthy kids already that were born naturally without any complication, so this experience has been very hard on me. All I can pray for is that if indeed my baby is not alive, that it passes naturally soon. I'm suppose to be 11 weeks today.

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    1. I am just so sorry you are going through this. Stay closely monitored. (((hugs)))

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