Treatment & Procedures


Miscarriage Treatment and ProceduresMiscarriage is such an individual experience, that miscarriage treatment and procedures are different for everybody.

Miscarriage treatment and procedures*

*Please see your doctor should you require more detailed information.

If you’ve been for an ultrasound and it’s been determined that you have lost your baby, or you have had to make the heartbreaking decision to terminate your pregnancy for medical reasons such as a confirmed chromosomal or genetic issue with your baby, in general you can either:

(a) wait to miscarry naturally,
(b) elect to have a ‘dilation and curettage’ otherwise known as a D&C or
(c) take a tablet to induce miscarriage.

For some women, it’s not until they start bleeding that they know anything has happened to their baby, and you may have a complete miscarriage straight away.

You can be guided by your doctor or specialist as to the most appropriate way to progress for your individual situation. Generally, if it is a fairly early loss, waiting for the pregnancy to miscarry naturally will be the most common course of action. For later first trimester losses or if a missed miscarriage has occurred, a D&C is usually recommended.

Some women may have personal preferences around which method is best for them. Some believe that letting the body take its natural course is best. Some feel that a natural miscarriage would be too painful or traumatic and they’d rather have the pregnancy surgically removed so it’s over more quickly. Whichever option you choose, please make sure you have your partner or a friend with you for support.

Expectant Management

Experiencing a Natural Miscarriage

One of the hardest parts about waiting for a pregnancy to miscarry naturally, is not knowing when it will happen and it can be anywhere from a few days to a week or two.

Generally, once your HCG and progesterone levels begin to drop, you will start spotting or cramping and this will escalate fairly quickly to heavy bleeding. The cramps may worsen and feel like bad period pain or contractions, as your body works to expel the pregnancy tissue.

The bleeding will likely get fairly heavy and depending on how far along you are, you may also pass large clots of tissue. If you have spoken to your OB or treating doctor about having the tissue tested for abnormalities, you may want to try to catch it in a jar or plastic bag – though this can obviously be somewhat traumatic and practically speaking, may be difficult to do. After about 24 hours or so, your cramping should subside and blood flow will reduce.

You may continue to spot for up to a week or two after the miscarriage, but if any of the following occurs, please call your doctor or go to the hospital ASAP:

  • Severe abdominal pain or excruciating cramps that are not subsiding
  • You develop a temperature
  • An increase in bleeding and/or bleeding that is soaking a pad every few hours for more than 2-3 days
  • If bleeding lasts longer than 2 weeks
  • If bleeding stop/starts for longer than 2-3 weeks

You should have a normal period around 4-6 weeks after the miscarriage. Remember, you can fall pregnant during the first cycle after a miscarriage, however most doctors recommend you wait one full cycle before trying again.

Surgical Management

Having a D&C

If you are a bit further along in your pregnancy, ie 8+ weeks, or if you’ve had a missed miscarriage whereby the baby has already died but your body has not recognised it, a D&C is usually the most common course of treatment.

It is a fairly simple day surgery procedure that only takes about 15-20 minutes all up, though you will be required at the hospital for 4-5 hours, including time in recovery. The D&C is performed under a light general, and the doctor will remove the contents of your uterus while also scraping away the uterine lining. Your doctor will be able to send the tissue for testing if you wish.

Following the D&C, you should have some light bleeding for up to 2 weeks, though it may resolve sooner. If you need to take some paracetamol for cramps, do so, but any cramping should not last longer than 24 hours. You should avoid using tampons or having intercourse for at least 2-4 weeks after the D&C to prevent any infection from occurring.

Although it is a simple and fairly common procedure, a D&C is not without risks. These risks, while unlikely, include:

  • An adverse reaction to anaesthetic
  • Scarring of the uterus
  • Perforation of the uterus
  • Infection in the uterus

Medical Management

Taking Medicine to Induce Miscarriage

If you do not want to have a D&C, but also do not want to wait with uncertainty for your miscarriage to occur, you can opt to take a medication which will induce the body to expel the pregnancy.

The medication can be administered vaginally or orally, one dose per day for two days. Cramping and bleeding should begin 2-4 hours after the first dose and will last up to 24-72 hours. Some people may experience nausea, vomiting and diarrhoea but for most people, the process will be similar to that of an expectant (natural) miscarriage.

logo_the_womensFor more information, please visit the
Royals Women’s Royal Hospital, Victoria website.

 

 

Related Links

What is Miscarriage?
Causes of miscarriage

Signs and Symptoms

Source: https://www.thewomens.org.au/health-information/pregnancy-and-birth/pregnancy-problems/early-pregnancy-problems/treating-miscarriage/ Accessed 20th October 2016.