Miscarriage medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Medical Therapy
Blood loss during early pregnancy is the most common symptom of both miscarriage and of ectopic pregnancy. Pain does not strongly correlate with miscarriage, but is a common symptom of ectopic pregnancy. In the case of concerning blood loss, pain, or both, transvaginal ultrasound is performed. If a viable intrauterine pregnancy is not found with ultrasound, serial βHCG tests should be performed to rule out ectopic pregnancy, which is a life-threatening situation.[1][2]
If the bleeding is light, making an appointment to see one's doctor is recommended. If bleeding is heavy, there is considerable pain, or there is a fever, then emergency medical attention should be sought.
No treatment is necessary for a diagnosis of complete abortion (as long as ectopic pregnancy is ruled out). In cases of an incomplete abortion, empty sac, or missed abortion there are three treatment options:
- With no treatment (watchful waiting), most of these cases (65-80%) will pass naturally within two to six weeks.[3] This path avoids the side effects and complications possible from medications and surgery.[4]
- Medical management usually consists of using misoprostol (a prostaglandin, brand name Cytotec) to encourage completion of the miscarriage. About 95% of cases treated with misoprostol will complete within a few days.[3]
Psychological Aspects
Although a woman physically recovers from a miscarriage quickly, psychological recovery for parents in general can take a long time. People differ a lot in this regard: some are 'over it' after a few months, others take more than a year. Still others may feel relief or other less negative emotions.
For those who do go through a process of grief, it is often as if the baby had been born but died. How short a time the fetus lived in the womb may not matter for the feeling of loss. From the moment pregnancy is discovered, the parents can start to bond with the unborn child. When the child turns out not to be viable, dreams, fantasies and plans for the future are disturbed roughly.
Besides the feeling of loss, a lack of understanding by others is often important. People who have not experienced a miscarriage themselves may find it hard to empathize with what has occurred and how upsetting it may be. This may lead to unrealistic expectations of the parents' recovery. The pregnancy and miscarriage are hardly mentioned anymore in conversation, often too because the subject is too painful. This can make the woman feel particularly isolated.
Interaction with pregnant women and newborn children is often also painful for parents who have experienced miscarriage. Sometimes this makes interaction with friends, acquaintances and family very difficult.[5]
References
- ↑ Yip S, Sahota D, Cheung L, Lam P, Haines C, Chung T (2003). "Accuracy of clinical diagnostic methods of threatened abortion". Gynecol Obstet Invest. 56 (1): 38–42. PMID 12876423.
- ↑ Condous G, Okaro E, Khalid A, Bourne T (2005). "Do we need to follow up complete miscarriages with serum human chorionic gonadotrophin levels?". BJOG. 112 (6): 827–9. PMID 15924545.
- ↑ 3.0 3.1 Kripke C (2006). "Expectant management vs. surgical treatment for miscarriage". Am Fam Physician. 74 (7): 1125–6. PMID 17039747. Retrieved 2006-12-31.
- ↑ Tang O, Ho P (2006). "The use of misoprostol for early pregnancy failure". Curr Opin Obstet Gynecol. 18 (6): 581–6. PMID 17099326.
- ↑ David Vernon (2005). "Having a Great Birth in Australia".
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