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Back cramps, bleeding, ultrasound showed missed abortion. Shouldn't the doctor have looked for a blighted ovum?

May 2013
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Practicing since : 2006
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I am newly pregnant. LMP was around 4/14, I should be about 6+ weeks pregnant. I've had back cramping, and bleeding off and on. My OBGYN kept shrugging it off even though I know my body and knew something was wrong. Saturday I had an increase of blood loss when I went to the bathroom, so I went to the ER. They did a vaginal & normal US. They called it a missed abortion (terrible term BTW). They said to call my DR to follow up with more testing, but all she offered was a D&C. Is it not standard practice to re-evaluate what the ER diagnosis is? I'm a HR pregnancy, I had a stillborn daugther 4.5 years ago (26 weeks gestation with no cause). I've had one live birth and now this pregnancy or loss. I am going to get a second opinion, but shouldn't my dr have looked for a blighted ovum or a torn placenta, something other than offering just a D&C so quickly? I only seem to bleed when I am walking / standing or when I get stressed out. I know I could have an acutal miscarriage, but shouldn't it be confirmed and checked by my own dr, regardless of how "early" along I am? I am not passing large clots, I do not have terrible cramps (some back cramping), I am not passing tissue.
Posted Thu, 21 Jun 2012 in Pregnancy
Answered by Dr. Sree Gouri SR 9 hours later
thanks for the query.

I can understand your misery.
Normally being a high risk pregnancy you should be kept on additional cover of progesterone to prevent risk of miscarriage.

As I have not seen the reports, according to your description my interpretation is,
may be your doctor noticed in your first scan subchorionic hematoma etc which she might have thought to resolve with time.
And that may be responsible for your on and off bleeding and pain.
But finally it might have ended in miscarriage.

May be blood and clots from hematoma were lost before scan, because of that in ER they didn’t see anything in sac except the process of abortion.

As miscarriage was the diagnosis, sometimes heavy bleeding can occur if not evacuated early because of open sinuses and loss of retraction of uterus, may be because of that your doctor recommended directly D&C to you.

Anyhow as you want to take second opinion take it as early as possible and proceed accordingly.

Hope I have answered your query. I will be available to answer your follow up queries. If you are satisfied with all my answer, please rate the answer after closing the discussion.
take care.
Above answer was peer-reviewed by
Follow-up: Back cramps, bleeding, ultrasound showed missed abortion. Shouldn't the doctor have looked for a blighted ovum? 6 hours later
The er Dr and my Dr described that I will have heavy blood loss like after birth, I have not had this. I was not losing large clots. I don't undetstand how I could have lost everything with my minimal bleeding. Is a miscarriage typically a slow process? I have not bled since yesterday, and that wasn't enough to fill a pad even.
Answered by Dr. Sree Gouri SR 1 hour later

the possible causes for your less blood loss are,

-abortion might have occurred in the form of minimal but continuous blood loss.

-as it was only 6 weeks pregnancy too much blood loss like after birth may not be present.

-incomplete abortion: some products of conception are still remaining in uterus.

so you better consult gynecologist as early as possible, get examined and undergo ultrasound to find out the actual cause.

Wish you Good Health, If you are satisfied with my response please rate the answer after closing the discussion.

take care.
Above answer was peer-reviewed by
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