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Miscarriage Information

Miscarriage is the unexpected loss of an early pregnancy (less than 20

weeks) and happens when the fetus (baby) is not developing. About 1 in 4

pregnancies end in miscarriage.

Causes

Routine activities like exercise, lifting, sexual intercourse, travel, work, and

stress do not cause miscarriage. Miscarriage is most commonly caused by a

genetic abnormality and may be caused by uncontrolled diabetes,

uncontrolled thyroid disease, uterine abnormalities, or blood clotting

abnormalities. Genetic testing to help determine the cause of a miscarriage

is not always done but may be done where a woman has a history of

infertility or had more than 2 miscarriages in a row. Talk to your health care

provider for more information about testing.

No activities or treatments (bed rest, for example) have been proven to

prevent or reduce the chance of miscarriage.

Bleeding in Early Pregnancy

Bleeding in early pregnancy does not always mean that a miscarriage will

occur. Bleeding can be a result of:

 abnormalities of the vagina or cervix

 bleeding between the pregnancy sac and the uterus

 ectopic pregnancy - where the pregnancy is developing outside of the

uterus, which is a medical emergency.

Sometimes there is no explanation for bleeding in early pregnancy.

After a Miscarriage

It is normal to have bleeding for up to 3 weeks after a miscarriage. If you

are still bleeding after 3 weeks call the Early Pregnancy Assessment Clinic

(EPAC). It is normal to feel sad or upset about your miscarriage. It is

important to care for yourself during this time. If you would like to speak to

a counsellor or social worker please tell one of the EPAC nurses.

Pregnant After Miscarriage

After a miscarriage it is suggested that you wait until you have 1 normal

period before you try to get pregnant. Most women have a normal period

after 4 to 8 weeks. If your period does not return after 8 weeks, contact

your health care provider.

If you do not want to become pregnant again or at this time, talk to your

health care provider about using birth control. Options include the birth

control pill, condoms, patch, ring, or intrauterine device (IUD).

Go to the Regina

General Hospital

Emergency Department

if you:

have sudden severe

 abdominal pain

 suddenly feel faint or

feel like passing out

 save heavy bleeding

(soaking more than 2

maxi pads per hour for

more than 2 hours)

 have a fever greater

than 38° C (100.4° F).

To speak to a nurse at the

Early Pregnancy

Assessment Clinic (EPAC)

call:

(306) 766-4123

CEAC 1296

June 2020

Page 1 of 2

Regina Area

Treatment Options for a Miscarriage

Once an ultrasound has determined if a miscarriage

will occur you have three options. All options are safe.

The outcome of future pregnancies are not affected

by how the miscarriage is managed. The risk of

hemorrhage needing transfusion is less than 1%, and

of infection is 1 to 2%. Treatment options include:

 expectant management

 medical management

 dilation and curettage (D&C).

1. Expectant Management

This is when you wait for the miscarriage to occur

naturally. The wait takes an average of 2 weeks to

occur. Sometimes it takes up to 3 or 4 weeks and 80%

of women have complete expulsion of the pregnancy

by 8 weeks. Expectant management may be an option

for you if you are early in pregnancy.

Most women experience moderate to severe

cramping and bleeding which can be quite heavy for 2

to 3 hours. Some women have nausea. You may take

ibuprofen or acetaminophen for pain. After the heavy

bleeding you can expect bleeding like your period for

the following week and then light bleeding or spotting

for up to 3 weeks.

To reduce your risk of infection while bleeding after a

miscarriage:

 do not use tampons

 do not have sexual intercourse.

Most women who choose expectant management

have a complete miscarriage given time but some

need to have the surgical D&C procedure if there is

pregnancy tissue left in the uterus.

A follow-up phone is arranged after your Clinic visit

with the EPAC nurse.

You can call the EPAC for advice or to arrange a

follow-up visit.

2. Medical Management with Misoprostol

Is when the medication misoprostol is used to help

the cervix open up and the uterus to start the

miscarriage. We give you misoprostol tablets to take

home to insert into your vagina at an agreed upon

time. The miscarriage usually happens within 12

hours of insertion of the tablets. If it does not occur

within 24 hours you may be advised to insert more

misoprostol tablets into your vagina.

1 in 6 women who use medical management may still

need a D&C to remove tissue from the uterus.

Most women experience moderate to severe

cramping and bleeding which can be quite heavy for

2 to 3 hours. The misoprostol may cause side effects

including vomiting, diarrhea, shivering, and fever

which can last from 2 to 3 hours to 1 day. You may

take ibuprofen or acetaminophen for pain or fever

and dimenhydrinate can be used for nausea.

The EPAC nurse calls you within 72 hours of taking

the misoprostol.

You can call the EPAC for advice or to arrange a

follow-up visit.

3. Dilation and Curettage (D&C)

A D&C may be recommended if you are bleeding

heavily, have an infection, anemia, a bleeding

disorder, or cardiovascular disease. A D&C is a

minor surgical procedure where the cervix is opened

(dilation) and the pregnancy is removed using suction

(curettage) that takes about 15 minutes. A D&C may

be done in an operating room under general

anesthetic or in the EPAC under sedation with local

anesthetic. The wait for a D&C may be up to 1 week,

depending on your situation.

After a D&C, you may bleed for about a week. A

small amount of bleeding may be normal for up to 4

weeks after the D&C. Mild cramping is normal for 1

to 2 days. Risks of a D&C are rare but include

perforation (making a hole) in the uterus, tearing of

the cervix, developing scar tissue, infection

needing antibiotics and hemorrhaging.

CEAC 1296

June 2020

Page 2 of 2

Regina Area

 


 
 
 
 
 
 
 

 

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