Embryonic Resorption and Options for Miscarriage Management

Embryonic resorption, induced abortion?

Hello Doctor, my last menstrual period was on November 21, 2023.
Over the past six months, my cycle has varied between 28 to 41 days.
During my first ultrasound on January 7, the clinic doctor assessed that I was 4 weeks along.
Since I wanted to give birth in a larger hospital, I went directly to the big hospital for my second prenatal check-up on January 20.
The doctor said there was no heartbeat and advised me to come back the following week.
On January 27, the check-up showed no heartbeat again, and the assessment indicated that the embryo had regressed, recommending a medical abortion.
On January 30, I switched to Chang Gung Hospital, where the doctor said I was over 6 weeks along with no heartbeat.
Although he did not recommend an immediate medical abortion, he suggested allowing it to pass naturally and to come back after the New Year to check if everything had cleared out.
I would like to ask the doctor if waiting until after the New Year to handle this situation, without any signs of natural expulsion, will have any impact on my body? Is there still a chance for this embryo? Thank you, doctor, for your response.

Dora, 20~29 year old female. Ask Date: 2024/01/31

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, based on the situation you described, it is recommended to discuss with your physician whether to continue monitoring or to confirm the lack of embryo development and arrange for surgical intervention.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2024/01/31

More Info

I'm sorry to hear about your situation, and I appreciate your willingness to seek information regarding embryonic resorption and miscarriage management. It’s important to understand that the loss of a pregnancy, especially in the early stages, can be emotionally and physically challenging.
From your description, it appears that you have been experiencing a missed miscarriage, where the embryo has stopped developing, but the body has not yet recognized this loss. In many cases, the body will eventually expel the non-viable pregnancy tissue naturally, a process known as spontaneous abortion. However, this can take time, and in some instances, medical intervention may be necessary.

Understanding Embryonic Resorption
Embryonic resorption occurs when an embryo fails to develop properly and is reabsorbed by the body. This can happen for various reasons, including chromosomal abnormalities, which are the most common cause of early pregnancy loss. Other factors may include hormonal imbalances, maternal health conditions, or anatomical issues within the uterus.

Options for Miscarriage Management
When faced with a missed miscarriage, there are typically three management options:
1. Expectant Management: This approach allows the body to naturally expel the pregnancy tissue. It can take days to weeks for this process to occur. If you choose this option, it is crucial to monitor for any signs of complications, such as heavy bleeding or severe pain.

2. Medical Management: This involves the use of medications, such as misoprostol, to help induce the expulsion of the pregnancy tissue. This method can be effective and is often used when the body does not naturally expel the tissue within a reasonable timeframe.

3. Surgical Management: If the tissue does not pass naturally or if there are complications, a surgical procedure known as dilation and curettage (D&C) may be recommended. This procedure involves removing the tissue from the uterus and is typically performed under anesthesia.

Potential Impacts on Your Health
Delaying the management of a missed miscarriage can have various implications. If the body does not expel the tissue naturally, there is a risk of developing complications such as:
- Infection: Retained tissue can lead to infections, which may require antibiotics or further medical intervention.

- Heavy Bleeding: Some women may experience heavy bleeding if the body attempts to expel the tissue.

- Emotional Impact: The uncertainty and emotional distress of waiting for a natural miscarriage can also take a toll on mental health.

Regarding your question about whether the embryo has any chance of survival, it is important to note that once a heartbeat is not detected and the embryo is assessed as having stopped developing, the likelihood of a successful continuation of the pregnancy is very low.

Recommendations
Given your situation, it is essential to have open communication with your healthcare provider. They can provide personalized advice based on your specific circumstances, including the timing of follow-up ultrasounds and the best management approach for you. If you choose to wait for natural expulsion, ensure you are aware of the signs of complications and have a plan for follow-up care.

In conclusion, while waiting for natural expulsion is an option, it is crucial to monitor your health closely and consult with your doctor about the best course of action. Your well-being is the priority, and your healthcare provider can help guide you through this difficult time.

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