QuestionThank you for all of your kind help with my questions. Here is another if you please:
I had my ultrasound this past Wednesday, January 5th upon which they said I still have tissues in my uterus that hadn't passed. On that day, I was still passing stringy looking clots. After the ultrasound that same day, I met with my Dr. for an exam and she noticed a large mass of tissue stuck in my cervix (she wondered why the people performing the vaginal ultrasound did not pull it out). In any event, she pulled it out with forceps and believed that she just passed the tissues for me.
After my dr. removed the tissues, I bled the heaviest I've ever bled for about 2-3 hours then tapered off. (More bleeding than when I took the pills to induce the tissues to pass the week before). After about 3 hours, I passed a large jelly-like substance about the size of a golf ball and the following morning, passed another smaller (walnut size) jelly-like substance. In the days before that, I was just passing stringy looking clots.
After I passed the larger jelly-like masses, my bleeding tapered off and as of today, Saturday has stopped.
My questions are:
1. Does this sound like I passed all the tissues I needed to pass.
2. The tissues that got stuck in my cervix were thankfully detected by my dr. If she didn't detect them, would my body have in time, passed it on its own or would it have remained stuck there? The reason I ask is that I am concerned of more tissues getting stuck and me not feeling it. I didn't even realize anything was stuck until my Dr. told me.
3. Would there be signs in time that my body can give to let me know that tissues are "stuck" so I can take care of it in time without risking infection?
4. Based on the info above and that I've stopped bleeding, does the passing is complete?
5. When the person performed the vaginal ultrasound is it possible she pushed some tissues further up and caused these tissued to get stuck in the first place?
6. Finally, the vaginal ultrasounds were often painful, not severely, but it did cause discomfort. Can these ultrasounds be dangerous to the cervix or any other part of the body? I remember her saying that it hurt because she was pressing on my cervix. Is that par for the course?
My main concern is that no other tissues get stuck in my cervix. I'd like to know that if that happens again, that eventually my body will pass it on its own, without the dr. having to pull it out or at the very least that my body will give me some signs well ahead of time. My doc had me schedule another ultrasound in 2 weeks so that the bleeding has stopped completely. Since it has, I'm wondering if I should schedule it sooner.
Thanks again so much for all of your patience with my questions. You are a tremendous help.
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Followup To
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Thank you again for all of your help.
I decided to take the pills that I vaginally inserted at 4AM. It is now 3:30PM and I have just some minor bleeding. My Dr. said that I should have been bleeing quite heavily for 3-4 hours for the tissues to have passed. She said that the pills may not have worked. You mentioned to wait a week and if nothing passes to have a d&c.
1. So, is it then possible that I will still pass the tissue in the next few days even though my bleeding right now is minimal? Right now it's bit more than spotting, but it is not at all heavy. I also still am experiencing some cramping. I really want the pills to have worked.
2. Is it possible that I can bleed more heavily tomorrow and that maybe my body is just slow to respond to the pill? Or should I definitly have passed the tissue today?
3. I will have an ultrasound next Wednesday to see if all the tissues have been expelled. If not, I will have a d&c probably the following week. I am worried about waiting that long to have a d&c because I want to avoid infection. Is there any way to tell if there is an infection? And is it easily treated if caught by next week?
Once again, your input is extremely appreciated.
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Thank you once again for your prompt reply below. One other concern: Should I hold off on sex, excercise, etc, until the tissue has passed? Or are those activities okay?
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Thank you for your response to my question below. Tragically, upon reviewing my sonogram, my Dr. said that I miscarried. Now I am faced with options that I am not quite sure how to proceed. I have no bleeding yet so the Dr. said I have the option to wait until it happens naturally, to get a pill inserted to force the tissues out, or to have a d&c. I am nervous about having a d&c as it is surgery, but I am nervous that if I wait too long to let it happen naturally, there is a risk of infection. On my ultrasound there was a slight fetal pole, no heartbeat, and no embryo found. Based on that, what is your opinion on how I should proceed?
1.Is it safest for me to have the d&c and get all the tissue out or is it best to wait for my body to do it naturally?
2. If I go for the latter, is there a way to know that it got all the tissue out?
3. If infection occurs, is there a way to treat that safely?
4. Is there a way to detect infection early so it can be treated?
5. Is a d&c considered a routine procedure?
Thank you for your help with these concerns. I want to choose the best method that will keep my body safe.
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HI - Please help as I am very concerned. I am 33 years old. This is my first pregnancy. The first day of LMP was October 13, 2004.
I am very worried as I just returned from my sonogram at what my doctor says is 9 1/2 weeks. They told me they are unable to see any form or fetal pull inside the g-sac. I was advised not to worry and that it could be just that my weeks are off. I had an irregular period prior to getting pregnant - usually a 35 day cycle. I went off the pill in September and got my period about 35 days after my last period. (Before the pill I was always irregular)
My last period was October 13. I took at a preg test Nov. 21 and 22 which were both positive. Is it possible that I am earlier than the drs originally estimated? If it's not the timing, what are the other reasons that a form/shape could not be detected in the g-sac. My doctor is still waiting to get the results from the ultrasounds so I haven't had a chance to speak with her yet. By what week should the fetal pole and baby be seen? Is this different for every woman.
Should I be concerned? I'm, realy scared. I still have pregnancy symptoms, although my breasts are not as sore. My blood work came back normal. My first sonogram showed that I did not have an ectopic pregnancy.
Please let me know what your thoughts may be.
Thanks for your help.
Answer -
We do not see a fetal pole or a fetus prior to 6 weeks gestational age (from the first day of your last period). At 5-6 weeks gestation, we only can see an empty gestational sac in the uterus. Ovulation occurs around 14 days prior to the first day of your period. If you have a 35 day cycle, you probably ovulate on cycle day #21. If your last period started on October 13, you probably ovulated on November 2 and should now be 9 weeks 2 days pregnant. By now they should have seen a fetus on sonogram. If they did not, your dates may have been incorrect. HOwever, since a pregnancy test will show a positive result 14-21 days after ovulation, and you got a positive result on November 21 zand 22, your dates appear to be correct. See what the next sonogram shows. However, if the next sonogram does not show a fetal pole, I'm afraid that we must consider thiw to be a "blighted ovum" (miscarriage). Symptoms of pregnancy can remain for a few weeks after a miscarriage. Be patient.
Answer -
You were well informed of your options. The only difference between allowing nature to take its course and wait for the tissue to expel on its own, or to have a D&C and remove the tissue immediately, is the time factor. Allowing the tissue to pass on its own is frustrating because it involves some discomfort and bleeding. It can take several weeks. A D&C will remove everything at once and the bleeding will be controlled. In either method, I would take Methergine 0.2mg every 4 hours for 6 doses in order to control the bleeding and to contract the uterus. This should be taken even after a D&C. I would not worry about infection at this time. If you elect to do this naturally, once the cervix is closed and the uterus is back to normal size, you can assume that everything is out of the uterus. If there is any retained products of conception, the uterus would remain enlarged and the cervix would not close. Good Luck. I would choose to take the pills and wait one week. If nothing passes by then, and you still have bleeding, have a D&C done.
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In order to avoid any risk of infection, I would avoid any vaginal activity until the situation has resolved.
Answer -
You may get heavier bleeding later on this week, or you may have no bleeding at all. You still may have passed the tissue (it is microscopic, remember). The tissue can also reabsorb in your body. Give it uhtil next week when you repeat the sonogram. If there is still debris in the uterus next week, then have the D&C done. I doubt that you will get any infection. An infection is manisfested by fever and pus coming from the vagina, along with pain in your uterus.You are doing everything correctly. Don't worry.
AnswerIt sounds like all the tissue that was in your uterus has passed and, if your cervix is closed and the bleeding has tapered off to none, you are back to normal. You can start trying to conceive after your next normal period. It is not the job of the sonographer to remove any tissue that is stuck in the cervix. The job of the sonographer is merely to insert the vaginal probe and diagnose if there is any tissue in the uterus. Once that tissue was removed from your cervix, it allowed the rest of the mucus membranes, depbris, etc. to evacuate itself. Even if your doctor had not manually removed the tissue that was in the cervix, it would have eventually passed on its own. If there were more tissue in your uterus that remained, you would continue to bleed heavily until it passed or was removed. A sonogram is not dangerous and it is impossible to push tissue back into the uterus once it is being extruded. Don't worry. In two weeks, when you take the "follow-up" sonogram, it should show a completely empty uterus. You do not need to take the sonogram sooner. Once the bleeding has stopped and your cervix is closed, the episode is over. Don't worry.
