Management of Miscarriage

Sometimes during a pregnancy, some things go wrong and the baby would be lost. As hard and painful as it is for the mom, she has to decide whether she wants to undergo a procedure – dilation and curettage (D&C) – or let things take a natural course.

Of course, if a medical emergency is involved, then there is no other choice for the mother but to go through surgery. Examples of emergencies include ruptured ectopic pregnancy or a hemorrhage.

Medical emergencies aside, whichever treatment option you take, you must weigh things carefully, and choose the safest way possible.

Natural miscarriage

Once your doctor diagnoses a miscarriage before you started bleeding, it is going to take weeks without intervention. Though the process of waiting is long, plus physically and emotionally difficult, statistics show that 80-90% of women who decide to take the natural course will miscarry in about 2-6 weeks without complications.

If you have already started bleeding but decided to wait anyway, be sure to follow your doctor’s orders. You should also see your doctor for a follow-up check up to see if your uterus is clear and if your human chorionic gonadotropin (hCG) levels are back to zero.

Women sometimes avoid procedures that would speed up the miscarriage such as surgery and D&C because they either want to get the tissue (for burial) or they want to avoid the risks that come with surgery or other procedures.

These procedures may also be too invasive for some mothers. Some women also want to avoid the trouble of going and checking into the hospital.

Early pregnancy miscarriages feel very much like having your period. You will feel either mild or intense cramps and will see brown spots that will become heavy bleeding with large blood clots.

Bleeding may go on for a couple of weeks and may range from light to heavy. Unless you soak through a pad in less than an hour, you may not go to the emergency room. Still it is best to be safe. To help you deal with the cramps, your doctor can prescribe pain killers.

Medications to speed up an inevitable miscarriage

If you are diagnosed with an inevitable miscarriage but have not yet started bleeding and do not want to go through surgery or D&C, then your doctor may prescribe medications such as misoprostol, a prostaglandin to speed up the process. This would be just like letting things take their natural course, except things are sped up by the medication.

Medications are prescribed to treat confirmed or possible ectopic pregnancies, provided that they are not in danger of bursting or rupture.

These medications are safe for most women. However, they do pose risks or hemorrhage and cramping. Your doctor should warn you early on if it appears like you will require medical attention. Avoid traveling as well, unless your doctor has confirmed that your miscarriage is complete.

Dilation and curettage

A third option for managing miscarriage is dilation and curettage. The mother may or may not check into the hospital, depending on the situation. In D&C, the mother will be go through a pre-surgical workup, then given either a local or general anesthesia.

The doctor then dilates the cervix and then scrapes away and/or vacuums the uterine lining. The mother may be discharged that same day and just come back for a follow-up check up a few days or a few weeks later.

D&C may be required if the woman’s life is in danger. For instance, if she is hemorrhaging or has tissue left in the uterus after a natural miscarriage. Surgery is also recommended for ectopic pregnancies and late pregnancy miscarriages.

D&C is also provides the opportunity to collect tissue and chromosome analysis. This would rule out chromosomal abnormalities in repeated miscarriages.