Misoprostol for Treatment of Early Pregnancy Loss
What can I expect?
A missed abortion refers to a fetus that is no longer living but the tissue of the fetus has not come out from the uterus. It occurs in 15 to 20% of all pregnancies. It happens more often in pregnancies that are 13 weeks or less. The reasons for it are unclear.
- Waiting for fetal tissue and uterine lining to pass on its own.
- Surgery to remove tissue (D&C or manual vacuum aspiration).
- Treatment with the drug misoprostol.
How is misoprostol given?
Four tablets are placed under the tongue. This is done at home. Misoprostol will loosen fetal tissue and uterine lining. This drug will cause the uterus to contract and dilate the cervix within a couple of hours. It will take about 4-16 hours to pass the tissue. Sometimes, a second dose is needed if the tissue is not passed within 24 hours.
- You will have vaginal bleeding likely heavier than a period for 3 to 7 days after your treatment. Bleeding may vary from heavy with some clots to only slight spotting. Spotting may go on for over 2 weeks.
- You may feel tired. You may even have severe cramping for up to a week after the tissue has passed. A heating pad and pain medicine (AdvilÒ, AleveÒ, MotrinÒ) can be used to help with the cramping. If cramping is so severe that you can’t do your daily routine, please call.
- Eat lightly for the first 12 to 24 hours. Nausea and some vomiting are common.
- Your next period should occur 4 to 6 weeks after the miscarriage. If you do not get your period, please call.
- No intercourse or use of tampons for 2 weeks. You can still get pregnant shortly after miscarriage. Severe infection may occur from intercourse.
- You should feel well enough to resume your normal routine within 48 to 72 hours. Intense activities such as horseback riding, jogging, and heavy exercise may increase bleeding and cramping.
- Symptoms of pregnancy (i.e. breast tenderness, nausea) should go away within a week. If breasts become full or leak, wear a tight bra night and day. Less breast stimulation will also help.
- Feelings after miscarriage can run the spectrum from the blues to depression. The milder forms are more common. If you need support, there is help. Please call your midwife, or doctor. We have a trained counselor in our clinic they can refer you to. Seeking help is the best thing you can do if you are having trouble handling these feelings on your own.
When to call:
- Temperature over 101° F
- Prolonged heavy bleeding (soaking more than one pad per hour for greater than 2 hours)
- Severe lower stomach pain
After hours, weekends or holidays, this number reaches the paging operator. Ask for your doctor. Give the operator your name and phone number with the area code. The doctor will call you back.
If you live out of the area, please call 1-800-323-8942
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 03/01/2012
Copyright © 01/19/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6077
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