Download DECISION BOARD

DECISION BOARD
Early Pregnancy Loss Clinic
Women’s Health Centre
SPONTANEOUS MISCARRIAGE
PROS
Miscarriages are common and occur in 15-30% of all
pregnancies. Having a miscarriage does not mean you will
not carry a normal pregnancy in the future. Miscarriages
are not your fault.

Able to be at home during the process.

Expulsion of the products of conception (POC)
without the assistance of either medical or
surgical means (D&C)

This is a natural process with an unknown
timeline.
CONS

Length of time for the process to complete and
the potential prolonged draining of the emotions
of you and your significant other

Fear of the unknown – especially with the first
pregnancy

If the miscarriage is not complete (some of the
products of conception do not expel) there is a
chance that a D&C may be needed.

If bleeding severely, i.e., soaking one pad per
hour for two hours or soaking a full pad in one
half hour for one hour you must seek medical
attention at the nearest Emergency Department
for potential D&C.
ADMINISTRATION OF VAGINAL MEDICATION
PROS
This method is commonly used worldwide and is 89 – 98%
effective. If a follow up D&C is required the medication
has begun the process of dilating the cervix which will
assist the surgeon and yourself. This pre-dilatation should
therefore reduce your operative risk.
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CONS

Minimally invasive medical procedure.

Fear of the unknown – emotional upset

High rate of effectiveness on the first
insertion. Two insertions may be necessary

Cramping and Bleeding

May end up with a D&C

Must be willing to return to clinic for
several visits, as necessary

60+% of patients will begin to miscarry on first
dose – usually 8 hours after insertion. This will
be evident by increased cramping and some
bleeding.

Process timeline usually 48 hours to 3 days.
MISOPROSTOL ONLY REGIME
Effects of fetal demise process:
COMMON SIDE EFFECTS
Cramping - Often described as similar to menstrual cramps.
Nausea
Bleeding
Vomiting
Average bleeding time usually 2 weeks.
Diarrhea
Often described as similar to a heavy period in a spontaneous
miscarriage.
Headache
OF THE
DRUG
Dizziness
Fever and Chills
Rashes
Pelvic Pain
DILATATION
AND
CURETTAGE. (D&C)
PROS
This is the surgical stretching (dilatation) of the cervix
(opening into the uterus) and the gentle scraping away of
the uterine contents. This lining is normally shed during
the menstrual cycle each month.
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CONS

Procedure booked and performed usually within
a week.

Use of anesthetic and surgical procedure is invasive,
and therefore has risks.

Able to return to usual daily activity after 24
hours, or when you feel able to do so.


98-100% effective.
Possible complication of infection as noted by – fever,
foul smelling discharge, persistent abdominal pain not
relieved by analgesic, continuing to pass clots or bleed.

If you get an infection following, this may cause
damage to uterine lining (Asherman’s Syndrome) and
may make future pregnancy implantation difficult.

Possible uterine or cervical damage.