D&C for retained products...anyone been down this path?

Hi guys!

Need some BB insight into the world of retained products of conception (RPOC)...'cause that's where I am at :)

Basic history is that i had a baby 8 weeks ago. 5 weeks post partum i had a PPH with infection from suspected RPOC. admitted with IV ABs for 48 hours and 2 weeks of 2 different ABs. had breakthrough bleeding the whole time so went for scan at end of ABs and they found and confirmed continued RPOC (with arterial vascularity). public hossy said that the product is borderline on whether they will do a D&C or not and recommended another scan in 2 weeks. did that and still there...and bigger. (please note, that scans were not taken at the public hospital as they did not have the space so went to two different private places).

Basically have been told that I can:

A) wait for the next round of ABs to finish (just started tonight) and then rescan, or,

B) present to hospital with letter from GP (which he gave me today) and scan results (both of them) and ask for the D&C and see where we get.

I guess my question is: for those of you that had a D&C for RPOC at what point did you or your care-providers tell you to get it?

My GP, IM and the sonographers all believe that it will need a curettage to resolve, but the hospital is reluctant (public). I can put my foot down apparently, but also understand that there are reasons to treat RPOC conservatively (ie without a D&C)...but I am in pain, have a fever and am on ABs and have persistent bleeding...and am generally not having fun, so am tempted to have the D&C to feel that there is resolution.

I am conflicted!

No experience, but lots of :hug: for you.

I honestly don't know which I would choose... both options make me fearful! Whatever you decide, I hope the situation resolves quickly and you can get down to the business of being mama.

No help here, but that sounds rough! :hug: Surely it's time to move on to the next option? I hope you're feeling better very soon

If it were me....I'd be demanding a d&c
Xxxxxx

I'd be insisting on a d&c too purely because it will speed up recovery and you have a baby to look after. I can understand why they are recommending a conservative management but you are within your rights to request a second opinion and strongly push for the treatment you want.

I had the same, due to my massive PPH the hospital were reluctant to do a D&C.. I had Ab's but finally after 9wks I demanded something be done.. They did it and 2 weeks later I stopped bleeding and have had no issues since.. I wish they had done it MUCH sooner. My advice.. DO IT!! It's so tough feeling like crap and continuously bleeding.. Hope you recover soon, whatever path you take :hug:

ETA: I was terrified to have a D&C as I had suffered very severe birth trauma, but it honestly was the best decision.

thanks so much guys. I am really feeling so overwhelmed by it all. basically it is only the hospital that is now needing to be coerced really. I do have the option of going private (but will be out of pocket) and will do so early next week if the public hospital cannot see me and offer real 'end dates' for this.

Even after seeing two different GPs at two different practices they both recommend that i see a specialist to have a D&C. i think that that time has come TBH.

I do feel that i have taken a conservative measure so far, but honestly, it does seem like an excessive amount of time ITMS. Dude, i have even gone down the path of acupuncture and the naturopath to help jiggle the bits outta me :lol:

So after the D&C for those that have had one, did you all feel ok? where there any further issues (ie not getting all the product, further infection). i know that asking these questions can have varied answers but I do feel i need to touch base with those that have BTDT ITMS. it does seem scary...both scenarios...leaving it and risk infection after infection or D&C and risk scarring etc.

more :hug: it's only natural to feel overwhelmed! Wishing you the best of luck.

Absolutely no issues. I had a spinal, but I also had some sedation because I didn't want my birth trauma triggered. I had the D&C at 12pm and was down in NICU with bub (catheter and all ;) ) by 10pm that night. Bled for 2 weeks and felt so much better!

ETA: I didn't have to worry about the scarring issue as I wont have anymore children, but I totally understand your concern there :(

I had a d&c for retain products. I was bleeding white heavily and quite uncomfortable. From what I understand your uterus will keep forming a clot around the product hence the bleeding. I am surprised the hospital won't do it ASAP to be honest. If I were you I would be. It's been a long time now and you will feel instantly better once its all done.


Sorry. Just read your latest post! I had no issues with mine what so ever. As I said, I woke up from it feeling a hell of a lot better!

Cass :hug:. I remember the head of the ER tell me once that sometimes patients need to "be assertive" to make the health system work for them. This sounds very much like your pub hospy diagnosis does not accurately reflect the severity of your symptoms, and so that diagnosis needs to be revisited. It's helpful to remember that when you interface with the public system, you're entitled to ask to be seen by the Consultant. The first couple of layers of people you speak to are usually registrars or even senior registrars. It helps if you can distil the story into 2 or 3 brief points, describing what's happened but focus on the reasons why they should perform the procedure. Remember the hospital indicated you should be reviewed after 2 weeks, so ask to be seen by the consultant. They usually have the power to make things happen. :hug:

I had this after a miscarriage. Had a dand c then a month later I couldn't walk with the pain. I had abs and my Dr did another d and c but used a camera this time to make sure it was all cleaned.

It wasn't as bad as I had expected and u can ask.for sedation. I felt a lot better within 2 days and has "fine" after. Week.

Hugs. Talk to the Drs and let them know if ur scared/ worried etc

Yep me but didn't have this trouble. MW suggested I go see Dr as on and off bleeding. Dr hard to get into so waited for appointment. Got referral for u/s. MW gave me the report so made an appointment which I waited awhile for. Seen Dr who wrote referral to see OB. Waited ages again! Rang every couple of days to see if got referral once they do had appointment the next week. She was great and said will do D&C next week (her usual day of ops) and squeeze me in. I had no fever just the on again of again bleeding. Had ABs day before D&C and then while in theatre (at this stage Bub was 16weeks)
:hug: Hun. Hope this is resolved soon!! Apart from feeling crappy and on and off bleeding I didn't have any other symptoms, you must feel horrible :( but yes push for that D&C so you can get back to feeling normal again.

Oh and felt heaps better after.

oh guys thank you so much for sharing! i feel so relieved to hear how instantly better you all felt once it was all done properly. I have been feeling so exhausted and woozy these last 9 weeks that i think i forget what it is to feel better haha.

they told me that any D&C i have will be under GA due to the fact that it is attached with an arterial vein. i'm ok with that...tend to be ok with GA and man, it is a good sleep :lol: jokes aside, thanks for the tips and insight!

I will have to fine tune my history of the stuff and ask to see the right person. the only people that my GP has been talking to are the registrars. i think that 9 weeks PP and two rounds of ABs is long enough to satisfy that it aint moving.

Oh and I had a hysteroscopy as well, make sure they do that so they can see its all Lear. Yep GA here too, could not be awake for that!!!

I had heard about the use of cameras being far more effective on this matter...makes sense really!

Are you still out of aus? cass? Or back in aus, can't remember?

Cass is back in oz. :)

Good luck with it, sweetie :hug:

Thanks MD, too much going on here I lost track!

Well if they don't do anything there come here I'll give you the name of the ob in seen you can get a referral too.

that would be awesome em :)

Hoping that Monday will be the Day of Action...well at least getting the ball rolling!

Hiya,

Just wondering how you went with it all?

I've just found out I have a fair amount of RPOC but I'm at the other end of the spectrum in that I've had barely any bleeding since birth at at almost 3 weeks PP am only spotting.

I found out last Friday and have had the run around since. I've been given a script of AB's and be told to just leave it as is. I'm not taking the AB's as I came home from hospital on the same stuff and it wiped out my gut flora and I ended up with thrush and dihhroea.

I don't particularly want a D&C as I think previous ones I've had have left scar tissue on my uterus giving me the troubles I now have with birthing my placenta.

I'm intersted to hear how you went :)

Hi Sara!

I was hoping to remember to come back in here and update! so thanks for reminding me :)

Bummer about the RPOC :(

Basically what I ended up doing was waiting and seeing. But to get to that point (and feel ok doing that) was to follow my IMs advice and see a private OB for advice and to get a clear answer from someone that can see the results of the scan and, if need be, do a D&C.

In my case we went and had the scan and results. he told me that although he could do the D&C (and that it was my choice) that he would recommend giving it another two weeks (i was at this stage 10 weeks PP). he felt that going by the size (under 30mm) that it would eventually break away and come down. he recommended a follow up scan in two weeks and if there was no sign of detachment from the the uterine wall, then to discuss and book in for a D&C.

he told me to take (another!) round of ABs. i got the script filled but like you, only opted to take them at the first sign of infection.

So that meant taking my temp every 4 hours during the day. checking the discharge for any smell (in my case never had this). for me, i would get a low grade temp as my first sign and some tenderness in the uterus area. i would check your belly often for tenderness.

In the end i didnt need the D&C. it did come away. I did go to the naturopath for some help, saw an acupuncturist and had my homeopath in italy send me out some of her stuff to help get rid of it.
I was recommended to keep taking the arnica too.

HTH xx

Thanks heaps Cass.

At this point I'm not showing any signs of infection. My temp has been sitting around 37.4 for the last week or so but I have no uterine tenderness or smelly discharge.

The last day or two I've noticed a little bit of fresh blood on wiping and have been feeling some random period type cramping so I'm hoping my body is getting ready to pass it itself.

I've had a scan on Wednesday which confirmed the RPOC but didn't document the amount. The original scan said 16cc which I'm pretty sure is 16mls. I dunno if this equates to a decent amount. What was telling to me was the Synographer on Wednesday could see the RPOC while I had an empty bladder (I was getting an abdo scan for flank/kidney pain I've been having). When I asked her how much there was she said enough to be of concern. But noone seems to be concerned. Its frustrating.

Can you tell me more about the natural therapies you used? How much do you think this helped in passing it?

Sorry to bother you with so many questions :redface:

Thanks hun
xx

Mine has been passing naturally, I'm hoping it's all passed now as my bleeding has almost stopped (but then it's been stopping and starting for weeks now). Scan indicated that it was coming away and not quite large enough to be removed via d&c. I've been taking ABs but so far I haven't really responded, the infection got quite nasty and I've been feverish for about 3 weeks now (on abs for 1 week) so ill probably be back at the doctors on Monday to see what's up. I hope it all passes naturally for you Sara, it totally sucks.

yeah, have to add with the infection that i had, i was on two types: a penicillan and one nasty one called 'flagyl'. killed the infection...but yeah, it really has a good wiping out of your own gut flora.