D&C necessary for miscarriage at 6 weeks 5 days?

Dear community,

I am facing a difficult choice and need your advice. I am visiting China when spotting started 2 days ago. I was 6 weeks 5 days. Went to ER the next day and they did an ultrasound. They were still able to see the sac and heart beat. I was prescribed Dydrogesterone tablets. But since I got home from the hospital, the bleeding increased dramatically and passed lots of blood clot. I went to ER this morning for another ultrasound. I was told I was having an “unavoidable miscarriage”, the tissues are still not passed. The doctor strongly recommended me to do a D&C immediately to avoid infections.

I had a previous miscarriage in SF, at 6 weeks. At that time, I was just sent home and was told to come back in another week to check my HCG level. Anyone please has any experience/advices to share? I would rather wait it out but of course don’t want to end up with infections/complications while away from home. Thanks.

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I'm sorry about your loss. I don't think there is a right answer. I can tell you that when I miscarried it stopped developing around 7 weeks but spotting didn't start until 12 weeks. I had uncomfortable cramping and spotting about 10 days and eventually went the D&C route. Honestly, if I had to do it again I would have done D&C immediately. Much easier, faster closure, and wouldn't have to worry about infection or anything. Good luck! 

Hi Eski, I am so so sorry for your loss. I had a missed miscarriage with my first pregnancy at 11 weeks and was advised to do a D&C when the pills didn't work. Unfortunately the Kaiser Oakland doctor who performed the D&C did a very bad job and severely damaged my uterus, leaving me with Ashermans Syndrome, where instead of being an open cavity where a baby can grow, your uterus is filled with dense scar tissue. As a result, I was told I would never be able to carry a child. I then read every medical article I could find and learned that after a miscarriage you are quite susceptible to developing this condition unless precautions are taken, liking doing a D&C guided by a hysteroscope. Ultimately I found an amazing surgeon who was able to repair my uterus and I was able to get pregnant, but my pregnancy was complicated and high risk because of placenta previa, which is common among people who have had Ashermans. My son had to be delivered via emergency c-section a month early to protect me.

That is a long way of saying, please proceed with caution. Ask if you can wait longer or take other steps to avoid a D&C, or if the D&C can be done guided by a hysteroscope, and please make sure you are working with a very skilled doctor. I am so sorry you are going through this, my heart goes out to you. I will try to also send this to you privately so you can respond if you have questions.

First of all, sorry that you're going through this. I started to miscarry at the same time and was heading out of the country a few days later. They were concerned that I would have major bleeding in the air or but be able to get medical attention quickly if bleeding didn't stop so we did the d&c and it gave me to piece of mind to travel safely and feel like I wasn't in danger. I also found out 4 weeks after the trip that I was pregnant again..apparently you're the most fertile right after a miscarriage. We now have a 13 month old.... Thinking good thoughts for you whichever you choose

I don't have any medical advice but wondering if you're able to contact your primary care physician or OBGYN at home and see what they advise. It might be helpful to get some advice from a medical professional you have some experience with. 

I imagine this is also emotionally difficult. Thinking of you and wishing you strength and love. 

I am so sorry for your loss. I've had two miscarriages, both at around ten weeks. I was bleeding and assumed that I had passed the fetus, but I had not. Cramps a few weeks later and I passed what was later confirmed as a six-week-old fetus. It sounds awful, but I was more intrigued by that time than anything else. There was more to this story, but I don't remember it now! I just know that my body's wisdom passed what was not viable. The fetus stopped growing at 6 weeks in both my miscarriages. I had no issue with any infections with this first one even though I obviously was carrying around tissue for a few weeks.  The second miscarriage I was passing a lot of blood clots and went to the ER in the middle of the night. They kept checking for the fetus, but I had not passed it. They did an ultrasound and saw lots of tissue so I opted for a D/C that time. The second miscarriage was more traumatic than the first due to a number of factors, including a very nasty doctor on call. I don't regret the D&C, but it would never be my first choice. I would first give me body a chance to do its thing, and if that wasn't working I would do what was necessary to avoid infection. This was a personal choice and not necessarily the right one for everyone. Good luck. I was 38 for the first miscarriage and 42 with the second. I decided not to try anymore after the second one. Good news is that I had a healthy baby boy in between who is now 20 years old! He was and still is a good egg! :)

First, I am so sorry you are going through this - I know how hard it is. I had a miscarriage at 11 weeks, and was also advised to have a D&C since, like you, lots of spotting and the tissue had not passed. I had the D&C with no issues and in the end, I was glad I did it.  The good news is I became pregnant with my daughter shortly afterward the miscarriage, and had a healthy full term pregnancy. Thinking you and wish you the best!