firstScan Miscarriage Management Choices

In the unfortunate situation that a pregnancy has ended but a complete miscarriage hasn’t happened then a woman will be offered a choice about the management available to them. These choices will be offered by the hospital not firstScan or Window to the Womb, but it is important that you know what they are:

• Surgical: This is an operation to remove the remains of your pregnancy and it is usually done under general anaesthetic (but see MVA below).
  • Evacuation of Retained Products of Conception
  • Manual Vacuum Aspiration – This is a simple procedure done early in pregnancy, which uses the suction of a syringe to remove the pregnancy tissue from the uterus. A local anaesthetic is used to numb the cervix and medicines to reduce pain and anxiety may also be offered.

• Medical: Instead of waiting for miscarriage to happen naturally, medical management uses medication to speed up the process of miscarriage.
  • The woman may have two types of medication, mifepristone, which blocks the hormones to the pregnancy and the second medication, misoprostol, which works by making your womb contract to push out the pregnancy tissue.
  • The hospital may only use one medication called misoprostol, if the pregnancy is less than 10 week size.

• Expectant: If a woman has a miscarriage in her first trimester, she may choose to wait 7 to 14 days after a miscarriage for the tissue to pass out naturally. This is called expectant management.
  • If the pain and bleeding haven’t started within 7 to 14 days or are continuing or getting worse, this could mean the miscarriage hasn’t begun or hasn’t finished. In this case, the woman should be offered another scan by the NHS.