Seeking Guidance on Complicated Miscarriage with RPOC and Ongoing Symptoms
Overview: I’m reaching out for support regarding my recent challenges after a miscarriage. Here’s a brief summary of my situation: I had a miscarriage on August 12, which led to a hospital visit due to fever and chills. I was given intravenous co-amoxicillin and misoprostol, but these treatments didn’t help. A D&C procedure was performed, which was also unsuccessful. After a second hospital visit, I was prescribed more antibiotics and additional misoprostol, but I continue to experience symptoms. Currently, I still have retained products of conception (2x7 cm) and fibroids, while my pregnancy test has returned negative. My doctors discharged me with the hope that the retained tissue would pass naturally with my next period, but as of now (September 12), I’m still cramping and have a fever. I’m concerned about possible endometritis. Should I wait, seek to induce my period, or advocate for a D&C or hysteroscopy? I’m worried about the implications for my fertility. Details of My Experience: - On August 12, I learned I had a missed miscarriage at 9 weeks and 5 days; the embryo had ceased developing at 6 weeks and 5 days. - After taking misoprostol, I passed the fetus along with substantial clots. - 12 days later, I was readmitted to the hospital with a racing heart, abdominal pain, and a fever. An ultrasound revealed retained products of conception (RPOC), suggesting an infection. - Initially treated with IV co-amoxicillin, I was switched to oral medications post-discharge. More misoprostol was given but proved ineffective, leading to a D&C. - Five days post-D&C, I was re-admitted due to severe cramps and recurring fever, where it was confirmed the RPOC still persisted at 2x7 cm. - I was put back on IV antibiotics, received a one-time dose of gentamicin (which provided me considerable relief), and more misoprostol, which failed again. - Despite tests conducted, there has been no follow-up communication about the swab results. Additional Health Aspects: - I also have subserosal fibroids, which are typically not harmful and grow outside the cavity of the uterus. It is believed my fibroids may have hindered the effectiveness of the misoprostol in fully contracting the uterus. - As of now, I have a negative pregnancy test. - After discharge, improvement in my inflammatory markers led to my release, but now I’m back experiencing cramps and a fever. - It’s been a full month since my miscarriage began, and I’m unsure when my period might arrive. - I fear the resurgence of my symptoms might indicate a new infection or endometritis. Medical Recommendations: - My doctors advised that undergoing another D&C shortly would not be advisable. - They also ruled out a hysteroscopy as being too invasive for this stage of my recovery. My Concerns: - This was my initial pregnancy, and I have a strong desire to become a mother. - I’m fearful of potential complications such as scarring (Asherman’s syndrome) that could impact my fertility. - I find myself unsure whether to: - Wait for my period (while anxious about the risks of infection), - Push for another D&C, - Or request a hysteroscopy. Questions for the Community: - Has anyone faced similar challenges post-miscarriage? - Did you experience RPOC after miscarriage that didn’t resolve with misoprostol or D&C? - If so, did your period eventually help clear it up, or did you require further medical intervention? Any insights, experiences, or comforting thoughts would be invaluable to me during this difficult time.
Answers (1)
9/12/2025, 3:20:56 AM
OpenHealth AI
I'm really sorry to hear about the challenges you're facing after your miscarriage. It sounds like you've gone through an incredibly difficult time, and it's completely understandable that you're feeling anxious about your symptoms and future fertility.
Main Points:
- Leftover tissue (RPOC) could lead to infection or other complications, and your continuing symptoms—like cramping and fever—could be warning signs.
- Given the complexities of your experience, it's important to prioritize addressing your symptoms and concerns about possible infection or complications.
- You have options to consider moving forward, but immediate focus should be on your current health.
Explanation:
Retained products of conception (RPOC) can indeed lead to complications such as infections (like endometritis), especially if you're experiencing ongoing fever and cramps. In your case, the presence of fibroids may have contributed to the difficulty in fully expelling the retained tissue, which is not uncommon. Since you've had multiple interventions without resolution, monitoring your symptoms closely is critical.
Your concerns about fertility are valid. Conditions like Asherman’s syndrome can arise from extensive uterine surgery, but maintaining the health of your uterus is the priority right now.
Next Steps:
- Monitor Symptoms Closely: Keep a close eye on your fever, cramping, and any other symptoms. Changes might necessitate more urgent medical attention.
- Contact Your Healthcare Provider: Inform your doctor about your ongoing symptoms. Given your current situation with cramping and fever, it's essential to discuss potential infection or the need for further intervention.
- Request Clear Follow-Up: If you haven't already, ask for clarification regarding test results and the next steps given your concerns about infection and retained tissue.
- Explore Management Options: Discuss with your healthcare provider the possibility of:
- Non-Surgical Options: Although you may have been advised against a repeat D&C or hysteroscopy, voice your concerns and see if they recommend any additional medications or therapies.
- Surgical Approval: If symptoms worsen or do not improve, your provider may consider revisiting the idea of a surgical approach.
- Emotional Support: Seek emotional support through friends, family, or professionals. Talking to someone who understands what you're going through can help relieve some of the anxiety around your situation.
Taking these steps will help you better navigate the challenges you're facing now. Remember, you're not alone in this experience, and there are many who care and want to support you on your journey.
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