Early Pregnancy Complications

Losing a pregnancy is a deeply personal experience that affects everyone differently. Unfortunately pregnancy loss is not uncommon. Following a woman’s first missed period the rate of miscarriage may be as high as one in five pregnancies. Most Miscarriages are a ‘once-off’ sporadic event and there is a good chance of having a successful pregnancy in the future.

The cause for miscarriages is still not well known.  A couple often worry that it is something they have done wrong that has caused the miscarriage but often this is not the case. Most commonly the cause of early pregnancy loss is a mismatch in the chromosomes. Chromosomes are required to ensure growth of the baby and if there are too many or too few chromosomes this may result in a miscarriage.

Following a miscarriage, some women have passed all the products and nothing more needs to be done. Bleeding, like a light period, may continue for several days until the lining of the uterus is completely shed. Other women may pass no products or only some products of the pregnancy. In most cases the products will pass with time but occasionally assistance may be required to empty the uterus.

Option 1: Wait and See

Following a miscarriage, if you have not passed all products you may choose to wait for your body to pass the products naturally. This option is not suitable for all forms of miscarriage.

  • Benefits: You can avoid surgery and an anaesthetic
  • Risks: You may notice ongoing bleeding, that may become heavier and may be associated with pain as you pass the products left behind. There is a small risk of infection and it may take up to three weeks for you to completely miscarriage.

Option 2: Medication

The medication used to assist with completing the miscarriage is called Misoprostil.  Misoprostil is a medication that softens and opens the cervix stimulating passage of retained products of pregnancy.

1-2 doses of the medications 24 hours apart is used to complete the miscarriage.  Follow-up will include ultrasound to ensure complete passage of products and blood testing to ensure pregnancy hormones return to negative.  If the medication is not successful surgical management may be required.

  • Benefits: You can avoid surgery and an anaesthetic. May quicken the approach in comparison to the 'watch and wait' approach.
  • Risks: Known side effects include flushing, passage of products can cause cramping and pain and if incomplete may require proceeding to surgical management.

Option 3: Surgery

The surgical option for miscarriage is called ‘Dilatation and Curettage’ and refers to the opening of the cervix and removal of the products from the uterus. It requires an anaesthetic to perform and is a short procedure.

  • Benefits: No delay in completion of the miscarriage.
  • Risks: There is a small risk of infection and injury to the uterus, as well as, the small risk associated to the anaesthetic.

Following a miscarriage it is common to have continued bleeding for 10 – 14 days while your uterus is returning to its normal size.

All miscarriages may be complicated by infection. If you have any concerns with ongoing or increasing bleeding, increasing pain, malodorous discharge or fevers please make sure you seek medical advice.

There is no time frame to wait to try again. The best time to try again is when you and your partner are physically and emotionally ready.

There are a number of support groups that you may wish to contact. I would recommend SANDS ‘Stillbirth and Neonatal Death Support Queensland Incorporated’ including miscarriage support. http://www.sandsqld.com/