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To: NHS
Make secondary scans before diagnosing miscarriage mandatory
Ensure NICE guidelines are followed and secondary scans are mandatory before diagnosing miscarriage to avoid unnecessary termination and a lifetime of sadness.
Why is this important?
Early October 2019,
I'd recently found out I was pregnant.
Not planned and I'm not ashamed to say that my plan going forward at that time was uncertain.
Shortly after, I began experiencing bleeding. Sometimes very light, sometimes nothing, sometimes heavy. Although I was aware that some bleeding in pregnancy can be totally normal, I was concerned it wasn't normal for me, having had 3 healthy pregnancies with no early bleeding.
I spoke to my EPU and was referred for a scan. By the time my appointment arrived, I'd been bleeding on and off for 12 days.
Firstly I was greeted by a lovely trainee GP who I spoke with, explained my choices were uncertain but I had suspected a miscarriage. I made it clear that had that been the case, I would like to progress with the surgical management option to recover, at least physically from the ordeal as quickly as possible. She agreed.
I was then scanned by another lady.
My scan confirmed something I didn't expect. Twins.
I was shown the screen and immediately felt a wave of guilt that I'd even considered termination.
Seconds later, the sonographer told me
One twin is significantly smaller than the other, I'm sorry but twin A has no heartbeat, I'm going to move on and check twin B'
Seconds felt like hours. Then, ' twin b hasn't either. I'm sorry but your pregnancy isn't viable'
At this point, my ears were ringing I couldn't process the information I'd been told.
Twins. No heart beat. Neither have heartbeats. Non viable pregnancies.
I felt like I was underwater while the world above continued.
I was escorted in to the room next door, back to the trainee gp I'd seen earlier.
The dr placed my scan photos, faced up on the table, clearly visible. I asked if I could take them, i was told no, due to data protection. But I could take photos while she had her back turned and pretend it hadn't happened.
Still to this day, I'll never understand why photos of my babies would cause a data protection breech...
I was handed a few forms to sign and a brown bag containing medication. At this point I reminded them of my want for surgical management route to be informed that because I'd miscarried, I would need to go to gyne and could be waiting days. She handed me the 1st tablet after explaining that she'd given medical management to 'help me out'
I was informed I needed to take the 1st tablet in front of them and then I was free to leave to continue my treatment at home, 24 hours later.
I walked out of the centre and I wasn't quite sure I even understood what just happened.
I went home and looked at the pictures I had taken of my scan.
Twin 1 measured 4.6mm and twin 2 measured 4.7mm.
Going by my LMP, 5th September 2019, I was 6 weeks and 6 days pregnant.
Mentally, I struggled. The days rolled in to nights, I led awake rearranging sernarios in my head. Forums, Google search and information pages became my life. I obsessed over it. Something didn't add up.
I was told during my scan that one twin was 'significantly smaller than the other'
My scans confirm that there was .1 of a mm between them.
After my nights and days of scanning the net, I was also aware that there are many cases where mothers attend scans and it's simply been too early to see a heartbeat and they attend a week or so later to see a healthy flicker on the screen.
Then it clicked.
My babies were too small to confirm miscarriage. But it was too late. The misdiagnosis had already been given and the medication to expell them from my body had been taken.
I began to explore the guidance set out by NICE. They state if the Crown to rump length is less than 7mm and no fetal heart beat is detected, perform a second scan a minimum of 7 days later, before a miscarriage can be confirmed.
In my case, this did not happen.
I was not offered a re scan.
I was not given the opportunity to let them develop. My choices were taken from me. Because, I trusted the guidance of a professional. A professional that do not choose to follow the guidelines of NICE that day.
For what reason, I have no idea. But there will never be an acceptable reason to justify what happened.
I want to change that. I want to make it mandatory that in early pregnancy, if a heartbeat isn't detected and there is a possibility that a heartbeat is not yet established, health care professionals should ensure expectant mothers should be called back, before a diagnosis of a miscarriage can be given.
Hospitals are given guidance to follow. But what I still struggle with on a daily basis is a prime example of why the change is so important.
Living with the uncertainty of whether my pregnancy was a healthy one or a non viable one is something I'll have to live with for the rest of my life. That could of been prevented by simply calling me back for another scan.
Please help me change 'guidance' to mandatory to ensure many more women don't have to go through the experience that I, and no doubt so many others have had to.
Thank you.
I'd recently found out I was pregnant.
Not planned and I'm not ashamed to say that my plan going forward at that time was uncertain.
Shortly after, I began experiencing bleeding. Sometimes very light, sometimes nothing, sometimes heavy. Although I was aware that some bleeding in pregnancy can be totally normal, I was concerned it wasn't normal for me, having had 3 healthy pregnancies with no early bleeding.
I spoke to my EPU and was referred for a scan. By the time my appointment arrived, I'd been bleeding on and off for 12 days.
Firstly I was greeted by a lovely trainee GP who I spoke with, explained my choices were uncertain but I had suspected a miscarriage. I made it clear that had that been the case, I would like to progress with the surgical management option to recover, at least physically from the ordeal as quickly as possible. She agreed.
I was then scanned by another lady.
My scan confirmed something I didn't expect. Twins.
I was shown the screen and immediately felt a wave of guilt that I'd even considered termination.
Seconds later, the sonographer told me
One twin is significantly smaller than the other, I'm sorry but twin A has no heartbeat, I'm going to move on and check twin B'
Seconds felt like hours. Then, ' twin b hasn't either. I'm sorry but your pregnancy isn't viable'
At this point, my ears were ringing I couldn't process the information I'd been told.
Twins. No heart beat. Neither have heartbeats. Non viable pregnancies.
I felt like I was underwater while the world above continued.
I was escorted in to the room next door, back to the trainee gp I'd seen earlier.
The dr placed my scan photos, faced up on the table, clearly visible. I asked if I could take them, i was told no, due to data protection. But I could take photos while she had her back turned and pretend it hadn't happened.
Still to this day, I'll never understand why photos of my babies would cause a data protection breech...
I was handed a few forms to sign and a brown bag containing medication. At this point I reminded them of my want for surgical management route to be informed that because I'd miscarried, I would need to go to gyne and could be waiting days. She handed me the 1st tablet after explaining that she'd given medical management to 'help me out'
I was informed I needed to take the 1st tablet in front of them and then I was free to leave to continue my treatment at home, 24 hours later.
I walked out of the centre and I wasn't quite sure I even understood what just happened.
I went home and looked at the pictures I had taken of my scan.
Twin 1 measured 4.6mm and twin 2 measured 4.7mm.
Going by my LMP, 5th September 2019, I was 6 weeks and 6 days pregnant.
Mentally, I struggled. The days rolled in to nights, I led awake rearranging sernarios in my head. Forums, Google search and information pages became my life. I obsessed over it. Something didn't add up.
I was told during my scan that one twin was 'significantly smaller than the other'
My scans confirm that there was .1 of a mm between them.
After my nights and days of scanning the net, I was also aware that there are many cases where mothers attend scans and it's simply been too early to see a heartbeat and they attend a week or so later to see a healthy flicker on the screen.
Then it clicked.
My babies were too small to confirm miscarriage. But it was too late. The misdiagnosis had already been given and the medication to expell them from my body had been taken.
I began to explore the guidance set out by NICE. They state if the Crown to rump length is less than 7mm and no fetal heart beat is detected, perform a second scan a minimum of 7 days later, before a miscarriage can be confirmed.
In my case, this did not happen.
I was not offered a re scan.
I was not given the opportunity to let them develop. My choices were taken from me. Because, I trusted the guidance of a professional. A professional that do not choose to follow the guidelines of NICE that day.
For what reason, I have no idea. But there will never be an acceptable reason to justify what happened.
I want to change that. I want to make it mandatory that in early pregnancy, if a heartbeat isn't detected and there is a possibility that a heartbeat is not yet established, health care professionals should ensure expectant mothers should be called back, before a diagnosis of a miscarriage can be given.
Hospitals are given guidance to follow. But what I still struggle with on a daily basis is a prime example of why the change is so important.
Living with the uncertainty of whether my pregnancy was a healthy one or a non viable one is something I'll have to live with for the rest of my life. That could of been prevented by simply calling me back for another scan.
Please help me change 'guidance' to mandatory to ensure many more women don't have to go through the experience that I, and no doubt so many others have had to.
Thank you.
