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Treatments and drugs
By Mayo Clinic staffIf you're having a threatened miscarriage, your doctor may recommend resting until the bleeding or pain subsides. You may be asked to avoid exercise and sex as well. Although these steps haven't been proved to reduce the risk of miscarriage, they may reduce bleeding and improve your comfort.
It's also a good idea to avoid traveling — especially to areas where it would be difficult to receive prompt medical care.
With ultrasound, it is now much easier to determine whether the embryo has died or was never formed. Either finding means that a miscarriage will definitely occur. In this situation there are several choices to consider:
- Expectant management. You may choose to let the miscarriage progress naturally. Usually this happens within a couple of weeks of determining that the embryo has died. Unfortunately it may take up to three or four weeks. This can be an emotionally difficult time.
- Medical treatment. If, after a diagnosis of certain pregnancy loss, you'd prefer to speed the process, medication can cause your body to expel the pregnancy tissue and placenta. Although you can take the medication by mouth, your doctor may recommend applying the medication vaginally to increase its effectiveness and minimize side effects such as nausea, stomach pain and diarrhea. For about 70 percent of women, this treatment works within 24 hours. If treatment doesn't work within 24 hours, you may experience the miscarriage within several days to weeks.
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Surgical treatment. Another option is a minor surgical procedure called suction dilation and curettage (D and C). During this procedure, the doctor dilates your cervix and gently suctions the tissue out of your uterus. Sometimes a long metal instrument with a loop on the end (curet) is used after the suction to scrape the uterine walls. Complications are rare, but they may include damage to the connective tissue of your cervix or the uterine wall.
In the case of an inevitable miscarriage, surgical treatment may be necessary to stop the bleeding.
- Zuccala SJ, et al. Spontaneous miscarriage. In: Ferri FF. Ferri's Clinical Advisor 2010. St. Louis, Mo.: Mosby; 2009. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-323-05610-6..00028-7--sc0160&isbn=978-0-323-05610-6&type=bookPage§ionEid=4-u1.0-B978-0-323-05610-6..00028-7--sc0160&uniqId=217216664-3. Accessed Sept. 7, 2010.
- Katz VL. Spontaneous and Recurrent Abortion: Etiology, Diagnosis, Treatment. In: Katz VL, et al., eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa.: Mosby; 2007. http://www.mdconsult.com/das/book/body/217216664-7/0/1524/100.html?tocnode=53759223&fromURL=100.html. Accessed Sept. 7, 2010.
- Simpson JL, et al. Pregnancy loss. In: Gabbe, SG, et al. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa.: Churchill Livingstone; 2008. http://www.mdconsult.com/das/book/body/217216664-3/0/1528/242.html?tocnode=57027393&fromURL=242.html#4-u1.0-B978-0-443-06930-7..50026-8_1154. Accessed Sept. 7, 2010.
- Early pregnancy loss: Miscarriage and moloar pregnancy.The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp090.cfm. Accessed Sept. 7, 2010.
- Tulandi T, et al. Spontaneous abortion: Risk factors, etiology, clinical manifestations, and diagnostic evaluation. http://www.uptodate.com/home/index.html. Accessed Sept. 7, 2010.
- Tulandi T, et al. Spontaneous abortion: Management. http://www.uptodate.com/home/index.html. Accessed Sept. 7, 2010.
- Puscheck EE, et al. The impact of male factor on recurrent pregnancy loss. Current Opinion in Obstetrics & Gynecology: 2007;19:222..
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 7, 2010.
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