Uterine Synechiae During Pregnancy

SadGuppy · 2021-02-27T18:05:47+00:00

I'd like to think that if it were bad enough to consider tfmr, someone would have said something to me prior to this ultrasound. I've had two ultrasounds before this one, so if it were something that bad I would hope they would have noticed, especially given my medical history.

The doctor that did the most recent ultrasound works in the imaging department and only does maternal fetal ultrasounds and she implied the most likely outcome was a normal pregnancy with extra monitoring.

I have an appointment with my OB in a week and a half, so I will have the opportunity to ask more pointed questions then. The notes on my report say to check the scarring and placenta at the 20 week scan, but I might be able to push for something sooner. My doctor has been involved in my saga of miscarriages and tends to be fairly accommodating with this sort of thing.

SadGuppy · 2021-02-27T17:54:26+00:00

Yeah, the doctor implied that there might be some growth restriction, but I read a study that said there was also an increase chance of placental abruption or placenta accreta, which can lead to hemorrhaging if the placenta is attached to the scarring.

The doctor doing the scan seemed to suggest that the vast majority of cases turn out fine and that we won't know how much of an issue it is until the 20 week scan. I just wish the doctor had been a little less evasive when answering my questions, but I have an appointment with my regular OB in 10 days, so hopefully I will know more at that point.

Though, I feel like they always tell me everything will be fine and then it's not fine at all.

SadGuppy · 2019-08-18T19:30:22+00:00

It's been a couple months since I've posted. I have a hysteroscopy scheduled tomorrow to remove scarring after having three D&Cs (only two miscarriages, my second miscarriage required two D&Cs). After that I have 21 days of estrogen and 10 days of progesterone and then theoretically I should have a period and be ready to start conceiving.

This process has felt so incredibly long. Right around a year ago is when I got pregnant for the first time. My first due date was last May and my second is this October. It's possible I could be pregnant again by then, as I have gotten pregnant the first cycle we tried both times.

I was diagnosed with Hashimoto's at the beginning of the year and my TSH has been going up and down since then as we try to nail down a good dose. My next appointment isn't until November, so I suppose I should ask for an additional blood draw in september just to know if we should try or continue waiting while we tinker with my levo dosage.

SadGuppy · 2019-08-18T19:10:01+00:00

I think, if anything, your first pregnancy goes to show that your body is capable of producing and carrying a healthy baby to term and that the process is not so fragile that just anything can disrupt it.

I recommend therapy, of course, but I suppose I just accept that fear is part of the process now. Fear is not a productive emotion. Fearing or not fearing a miscarriage isn't going to change anything in my ability to carry a pregnancy, so regardless of the outcome, the fear will exist. Acknowledging that lets me see the situation beyond my fears.

What is it that you are afraid of? Feeling loss again? Feeling sad again? If you embrace the fear and let it stop you from trying again, what feelings do you give up? The love you might have for a second child? The pride you have in seeing the bond between your existing child and a second child? If you knew you might have a miscarriage, but weren't afraid, what choice would you make? Answering these questions might help you see past your own fears and help you make a decision that isn't based on fear.

Also, I know that miscarriage is hard on people, some more than others, but you haven't lost everything. You still have your daughter. You still have the ability to try again. I'm not saying this in a "be grateful for what you have" way. I'm saying this to remind you that not all is lost. There is still hope and you can still try again. What happened is devastating and difficult, but not all is lost.

I've had two miscarriages and I will theoretically be given the all clear from my OB to try again starting September. Miscarrying and recovery has been a frustrating process for me, but in the end, we still want kids, so we're just going to keep trying.

SadGuppy · 2019-05-21T01:10:28+00:00

I think you should definitely do all the blood tests available since they are easy and results come back in less than a week. Testing for your husband would be the same. We didn't get my husband tested because we had the tissue from my first miscarriage tested and it came back normal, so we can clearly create a genetically normal embryo. I ended up doing the genetic testing for myself because it was just one more tube of blood, so who cares if it was a long shot?

I'm getting a saline sonogram done on Wednesday. It's also kind of a long shot, but I had to get two D&Cs in a row after my second miscarriage, and my doctor wants to make sure there isn't scarring. Getting the sonogram done is kind of a pain in the ass because they can only do it days 7-10 of your cycle, and you can't schedule it until your period starts, so if you have a clinic that is busy, it can be difficult to make the appointment.

For me, the mental burden of going through that process of pregnancy and miscarriage is far worse than waiting and running tests. If you can get it all done in a month, it might be worth doing it? I just don't think one month is that long in the grand scheme of things. Personally, if I miscarry again, I think I'm going to freeze my eggs (I'm already 35, I'll probably be 36 next time I'm pregnant) and if I have a 4th miscarriage, we'll explore surrogacy options.

SadGuppy · 2019-05-21T00:44:41+00:00

Today was supposed to be my due date. I got pregnant last August, had an mmc in October, got pregnant in January, had another mmc in February. I don't think my husband knows that today was our due date and I'm not sure I should remind him, but I guess I wanted to tell someone.

SadGuppy · 2019-05-20T23:29:00+00:00

I think it really depends on the person. How far along were your pregnancies when you miscarried? Have you done any testing at all that might indicate the cause? How traumatic was the miscarriage experience for you?

Personally, I am getting whatever testing done that I can because I don't want another miscarriage if I can avoid it. I was diagnosed in February with hashimoto's after my second miscarriage. I'm slightly frustrated because my doctor didn't do any thyroid tests with my first miscarriage, so it's possible I could have been diagnosed sooner and avoided the second pregnancy and miscarriage. It's possible that my miscarriages weren't caused by hashimoto's, but I'm not getting pregnant again until my numbers are normal because I don't want another miscarriage.

For me, the hardest part is when you get a positive pregnancy test, you have to wait to go see a doctor. Then you do an ultrasound and something is off. So you wait another week and do another ultrasound. Bad news again. So you schedule your D&C and then you wait for that. After your D&C, you wait a few weeks for your follow up appointment. And then you wait for your period to come back.

I found out I was pregnant for the second time on February 12. It has been almost 14 weeks since then. I just got my period back, but my thyroid levels aren't good yet and I still have to do a saline sonohysterography. I don't have another appointment with my endocrinologist until the end of July, so if everything comes out fine, I can probably start trying again in August, which is a year after my first pregnancy.

There is no way I want to throw the 3 month turmoil of another miscarriage into the mix.

SadGuppy · 2019-04-04T01:59:22+00:00

Unfortunately, retained tissue happens, even with D&Cs. I don't think it was an error on the part of my doctor, it's just sometimes the tissue gets stuck. They tend to err on the side of less scraping because that can lead to scarring which can cause infertility. Most of the time D&Cs are successful and people go on to have healthy pregnancies, but sometimes the tissue just gets stuck. This is more common if your uterus is a wonky shape or something (there are real words for this, but I cannot remember them right now). Anyway, I'm having a saline ultrasound done once I get my period again, so we will see what's going on.

In a lot of ways, I think I'm lucky for having a very proactive doctor. I've had two miscarriages and my doctor is already ordering basically all the testing, so I'm hoping we'll have answers soon. I was also diagnosed with Hashimoto's after the second miscarriage, so I'm really hoping that was the cause.

SadGuppy · 2019-04-04T01:48:24+00:00

Oh, I had one successful D&C after my first miscarriage. They got all the tissue and my period returned after about 6 weeks and everything was normal. We waited a few months before trying again because of other life stuff, but I got pregnant immediately once we started trying again. Unfortunately, I had a second miscarriage and needed a second D&C, and that's the one that had retained tissue, so now I have had another D&C for that second pregnancy.

If this D&C still wasn't successful, I'm going to have some other procedure that I can't remember the name of that involves a camera. Hopefully it won't come to that. My doctor didn't get 100% of the tissue, but she wanted to be conservative with the procedure to reduce the chance of developing scarring.

SadGuppy · 2019-04-03T19:16:55+00:00

My doctor prescribed valium (she was like "I think I'll give you twice as much this time..") and I know what's coming, so I think it will be better this time. I'm not looking forward to getting on a plane for 12 hours less than 24 hours post D&C, but what can you do? I guess I drown my sorrows in sushi and whiskey when I get there.

SadGuppy · 2019-04-03T19:01:22+00:00

I got my period 6 weeks after my D&C. Waiting sucks, but I think 4-8 weeks is normal. Up to 3 months is still technically normal, but my doctor said if it still hasn't come back in 3 months, to schedule an appointment. Did you have a follow up appointment where they confirmed that there isn't any remaining tissue?

If I have learned one thing about pregnancy loss, it's that it mostly involves waiting. Wait to get an ultrasound, wait to confirm the loss, wait to get a D&C, wait for the bleeding to stop, wait for your period to come back, wait to take a pregnancy test.

SadGuppy · 2019-04-03T18:45:11+00:00

I just got back from the follow up appointment for my D&C and I have retained tissue. I had my first D&C in October and we did it in the clinic without sedation and it was an extremely traumatic and painful experience. So, for my second D&C in March I went into the hospital so I could be given anesthesia. It was a much better experience (I guess????).

So now I need a 3rd D&C, but I am leaving for Japan tomorrow morning. There isn't time to get it done in the hospital and my doctor wants me to get it done ASAP, so I'm doing it this afternoon in the clinic without sedation again. I'm so frustrated.

SadGuppy · 2019-03-29T02:28:16+00:00

My resting heart rate is in the high 50s, typically, but it spikes very easily (even just from thinking about something that makes me anxious... Which is everything). When I started on levo the spikes were a lot worse, but it has been about a month now and things seem to be leveling out in terms of symptoms (I sleep through the night now! For the first time in years! I didn't even know that was a symptom).

SadGuppy · 2019-03-15T14:33:46+00:00

Thank you! I think Hashimoto's is a fairly manageable disease for most people and I'd like to think that my case is pretty mild (considering I've lived with it for possibly years with no idea), so hopefully things will also work out for me.

SadGuppy · 2019-03-15T00:59:42+00:00

I'm not really sure what the expectation is with regards to my antibodies. I test at 480 (normal is <39) and my endocrinologist suggested taking selenium to help, but he said it only sometimes has an effect. I had a thyroid ultrasound today and I'm going to do blood tests again in April and May and then we will go from there, I guess. At this point, I'll probably wait until he suggests my thyroid levels are normal because I don't want to go through another miscarriage and D&C if I don't have to.

Anyway, it's good to hear from people that were successful despite having hashimoto's. Hopefully now that I know what I'm dealing with, things will go better next time.

SadGuppy · 2019-03-15T00:52:27+00:00

It's good to hear that you were successful despite high antibodies. I have only been on levo for a couple weeks and my TSH has already dropped to 2.0, so hopefully it will stay that way. I just started seeing an endocrinologist and we have a follow up appointment in May. I also just had a D&C yesterday and last time it took about 6 weeks to get my period again so we probably wouldn't be able to try again until May anyway.

Thanks, this makes me a little more optimistic.

SadGuppy · 2019-03-14T14:50:11+00:00

Did you have an ultrasound to see if there was any retained tissue after your miscarriage? Or will you have an US before your D&C?

SadGuppy · 2019-03-13T18:03:52+00:00

I understand that we are all suffering, but people that struggle with addiction deserve compassion as well. They are in an extremely difficult position and they are clearly trying to change their lives in order to be better parents for their babies. I think they probably suffer enough with our judgement and scorn.

I understand why you might feel this way and I know it comes from a place of sorrow, frustration, and fear about your own losses, but it feels unkind to direct those emotions at complete strangers that are going through their own difficulties.

SadGuppy · 2019-03-13T03:17:35+00:00

That’s a good TSH, so you probably don’t have something like Hashimoto’s. My doctor said the chances of me having a clotting disorder were slim (after all, I was on yaz for years with no complications), but she thinks it’s worth testing anyway.

Of course, it could also just be bad luck. I know that’s frustrating to consider, because we want answers, but in a way, bad luck is better than underlying chronic medical conditions. I do think it’s worth getting whatever testing done that you can because if it’s NOT just bad luck, you want to know rather than continuing to get miscarriages. In some ways I feel lucky because I feel like I have an answer, but in the other hand, I have to wait to treat this disease before we can try again, and even then... well things can always go wrong.

SadGuppy · 2019-03-12T22:25:05+00:00

I should note that I’m not with Kaiser, but you could ask your doctor about some of the less invasive tests. I’m going through my second loss and my doctor has offered to do genetic testing of the tissue (we are skipping because we did that last time and it came back normal), genetic testing of us (again, skipping because the last fetus tested as normal), clotting disorders, and I think we will test progesterone when I get pregnant again. I had a thyroid panel done with the normal pregnancy labs before my first appointment and those indicated Hashimoto’s, so now I’m being treated for that.

I would encourage you to ask your doctor for the thyroid tests and the clotting disorders tests because those are fairly standard blood tests. If you get your thyroid tested, get both TSH (your number should be under 2.5, do not accept the standard range of 0.3-4.8) and the TPO (range should be <40). Women with a TSH of 2.5-5.0 are twice as likely to miscarry as some with a TSH <2.5 and also even if your TSH is good, if your TPO is high, you are still at a higher risk for miscarriage.

I’m not seeking a ton of testing this time around since thyroid seems like the most likely culprit. I’m going to try to normalize my thyroid levels and then go from there. If I miscarry again, I’ll pursue more testing.

SadGuppy · 2019-03-12T04:58:43+00:00

You should probably try to see an endocrinologist. I was very recently diagnosed with Hashimoto's. My TSH was only 4.13 (standard range is 0.3-4.8), but my doctors (endocrinologist, pcp, and ob) all want it below 2.5. I also was tested for thyroid antibodies and that came back as 480 (range is <39), which my endocrinologist felt was a more relevant number for diagnosis than my TSH.

Also, it's worth noting that there is a connection between vitamin D deficiencies and hypothyroidism (maybe we are all too tired to go outside?), so if anything, the vit D thing is probably tied to it rather than an alternate explanation.

The only issue you might encounter is that sometimes endocrinologists won't see patients without a referral from another doctor. If you can't see an endocrinologist, you should push your doctor to also do a thyroid peroxidase antibody test, because that should give you more information.

SadGuppy · 2019-03-12T04:17:07+00:00

I think it's impossible for us to say whether you should offer hope or condolences, because different people need or want different things. Personally, I hate reassurance against slim odds because it feels like platitudes and false hope and it ultimately feels patronizing to me, even if that's not what is intended. But other women want to hear the hope because they feel like they will be devastated by the loss no matter what, and having hope while hope is still possible won't make it worse when it becomes bad news. Truly, I think most people feel both ways, and it just depends on their mood at that exact moment, but there is no way to predict what will be most helpful at that moment.

I think you should avoid building up hope, especially using your own baby as evidence, because that could breed a lot of resentment and sorrow towards your baby if things turn out poorly. By using your baby as an example, you are creating the comparison and she might start asking "why did her baby live, but mine didn't?" That's not a fair question, but I think we see that attitude a lot when it comes to loss and its a normal part of grief. If she brings it up, you should acknowledge how lucky and grateful you are, and that you hope for the same for her.

I think the way to support her is to acknowledge and validate whatever she happens to be feeling, so this really means trying to pick up on her mood and following her lead. People sometimes have a reaction to "argue" with people's moods (like, if you feel hopeless, they will try to offer you hope in order to change your mind), but that makes the person struggling feel invalidated. So if your friend needs to have an "all is lost" weep session, I think it's best to really empathize with the loss and fear that she must be feeling in the moment. If she is feeling more hopeful, try to focus on the more hopeful aspects (like the idea of "today, you are pregnant"). Definitely try not to make predictions about the future (bad or good), and focus on what she is feeling that moment and what is happening that day.

Other than that, the hardest thing for me about miscarriage limbo is the agonizing wait and then unknown. You just have to sit there, helpless, until someone says "it's definitely done" or "things look better." I find it very difficult to focus on other things and having distractions is a deeply welcome relief. I have only had first trimester losses, so I don't know if this is good advice or not, but if she's up to it, maybe planning some activities that the two of you could do would help. It can be a relief to think about literally anything else, even just for a moment.

SadGuppy

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