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  Management of Miscarriage

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If a pregnant woman feels pain in the tummy, or notice vaginal bleeding, she should seek medical consultation without delay. She can go to her family physician, private obstetricians, gyaecologists or emergency departments of hospitals for assessment. Ultrasound scan can be used to assess the baby's condition and this causes no harm. Diagnosis of miscarriage is confirmed if the fetal heart is not beating or if the fetus does not grow. Therefore, several scans for fetal growth monitoring may sometimes be necessary before the doctor can confirm a diagnosis. What can be done before miscarriage is confirmed? Medical Treatment No medical evidence has shown that medication including hormones of any type is effective. Bed Rest Staying in bed cannot prevent spontaneous miscarriage. However, bed rest is still advisable when a pregnant woman bleeds heavily. What should be done if miscarriage has been confirmed? Admission If miscarriage is confirmed, evacuation of the uterus is usually suggested to remove the non-viable fetus in order to stop bleeding and to avoid infection.

Evacuation of Uterus A narrow suction cannula is inserted into the womb to suck the dead pregnancy tissues out. It can be performed under local or general anaesthesia. Variable degree of pain may be experienced after the operation, in which case painkillers can help. Physical Recovery after Miscarriage It is normal to have some vaginal bleeding in the first few days after complete miscarriage or evacuation of uterus. Normal daily activities and physical activities can be resumed once the woman feels energetic, that is, usually a week or two after the miscarriage. Sexual intercourse can be resumed after bleeding has stopped completely. Reminder after Operation If there is heavy bleeding, prolonged vaginal bleeding lasting more than two weeks, fever, or pain in the tummy after operation for miscarriage, immediate medical attention should be sought.
Psychological Recovery after Miscarriage It is crucial to understand that no one, including the woman herself, is to be blamed. It is common to have mood disturbances like shock, sadness, depression, anxiety, sense of failure and loss of self-esteem after miscarriage. She is encouraged to share her feelings with someone she can trust, e.g. husband, relatives, good friends or medical and paramedical staff to help her recovering from her grief. Good days always follow stormy and rainy days. One should always adopt an optimistic attitude and never be overcast by the shadow of miscarriage. Planning for next pregnancy It may be better to wait for two or three months before trying to get pregnant again. During this period of time, the woman can be recovering to her best possible shape for the next pregnancy, both physically and emotionally.

 
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Last revision date: 01 September 2006