women s health issues
Miscarriage
Treatment of Miscarriage
No treatment, if the pregnancy tissue has completely passed Observation of symptoms and waiting for the pregnancy tissue to pass on its own Medications or a procedure to help remove the pregnancy tissue Pain medication, as needed Rho(D) immune globulin if the mother has Rh-negative blood Emotional support If there is a threatened miscarriage (symptoms are occurring but ultrasonography shows a normal pregnancy), some doctors advise women to avoid strenuous activity and, if possible, to stay off their feet and avoid sexual activity. However, there is no clear evidence that such limitations are helpful. If a miscarriage is confirmed and the fetus and the placenta have been completely expelled, no further treatment is needed. If a miscarriage is confirmed, but all or some of the tissue from the fetus or placenta remains in the uterus, there are usually several options for passing or removing the pregnancy tissue. For an early miscarriage (before 12 weeks of pregnancy), if a woman does not have heavy bleeding or signs of infection, doctors usually explain several options, and a woman may choose to do one of the following: Closely monitor symptoms and wait for the uterus to expel the tissue on its own: A woman should receive instructions about what to expect, how to manage pain, how to recognize if the pregnancy tissue has passed, and when to call a doctor (if bleeding or pain is different than the usual for a miscarriage or a fever occurs). If the pregnancy tissue does not pass on its own, medication or a procedure is necessary. Take medication (usuallymisoprostol, sometimes withmifepristone) to help the uterus expel the pregnancy. Have a procedure to remove the pregnancy tissue from the uterus: Usually, a flexible tube is inserted through the vagina into the uterus and suction is used ( Surgical abortion ). If a miscarriage has passed on its own, doctors usually do blood tests for the pregnancy hormone hCG once a week until the level is undetectable, to confirm that no tissue from the fetus or placenta remains in the uterus. For a late miscarriage (between 12 and 20 weeks), doctors usually advise not to wait for the pregnancy to pass on its own, because this may cause serious pain or bleeding, and the pregnancy may not pass completely, causing infection. Late miscarriages are treated with one or more of the following options: A procedure to remove the pregnancy tissue from the uterus: This is called a Surgical abortion or Medications to induce labor and thus expel the contents of the uterus: These medications may includemisoprostol, sometimes withmifepristone(usually used earlier in the pregnancy) oroxytocin(usually used later in the pregnancy). Pain relievers are given as needed. All women who have an Rh-negative blood type and have had a miscarriage are given Prevention to prevent After a miscarriage, a woman and her partner may feel grief, sadness, anger, guilt, or anxiety about subsequent pregnancies. Grief:Grief for a loss is a natural response and should not be suppressed or denied. Talking about their feelings with another person may help women deal with their feelings and gain perspective. Guilt:Women may think that they did something to cause the miscarriage. Usually, they have not. Women may recall taking a common over-the-counter medication early in pregnancy, drinking a glass of wine before they knew they were pregnant, or doing another everyday thing. These things are almost never the cause of a miscarriage, so women should not feel guilty about them. Anxiety:Women who have had a miscarriage may wish to talk with their doctor about the likelihood of a miscarriage in subsequent pregnancies and be tested if needed. Although having a miscarriage increases the risk of having another one, most of these women can become pregnant again and carry a healthy baby to term. Additional testing is usually not necessary unless women have had 2 or more miscarriages. Doctors offer their support and, when appropriate, reassure women that the miscarriage was not their fault. Formal counseling is rarely needed, but doctors make it available for women who want it.Support groupsmay be helpful. 