Cytotec

Miscarriage is the most common type of pregnancy loss. Spontaneous abortion or miscarriage is the term used for a pregnancy that ends on its own, within the first 20 weeks of gestation.

The main goal of treatment during or after a miscarriage is to prevent hemorrhaging and/or infection. The earlier you are in the pregnancy, the more likely that your body will expel all the fetal tissue by itself and will not require further medical procedures. If the body does not expel all the tissue, the most common procedure performed to stop bleeding and prevent infection is a D&C. If a woman is less than 10 weeks, the doctor may have her safely miscarry on her own. Many women who miscarry do not undergo a D&C procedure.  After 10 weeks, the miscarriage is more likely to be incomplete, requiring a D&C procedure to be performed. Choosing whether to miscarry naturally or to have a D&C procedure is often  best decided after talking with your doctor and coming up with the plan of care that is right for you.

Soon after a woman chooses to naturally miscarry, the health care provider will schedule an appointment. Medication called Cytotec or Misoprostol will be administered in order to safely ensure that all the parts are expelled. This medication was originally used for treatment of ulcers but will also cause spontaneous abortions. The medication has been approved by the Food and Drug Administration (FDA) only for the prevention and treatment of gastric ulcers. However, studies have shown that Misoprostol off-label use for obstetric and gynecological purposes, including cervical ripening, labor induction. Cytotec causes the cervix to soften and the uterus to contract, resulting in the expulsion of the uterine contents.

Misoprostol can be taken by mouth and vaginally.  Before scheduling an appointment to take Cytotec, you should make arrangements to take off of work and have someone to drive you home. A speculum is inserted into the vagina and powder from the pills crushed Cytotec pills will be inserted using a sterile tongue blade. The regimen for pregnancies through 10 weeks is vaginal administration of 800mcg of Cytotec followed 24 hours later with the vaginal administration of a second 800mcg dose of Cytotec. Some health care professionals will give you 800mcg to take orally at home if all the parts are not expelled that day.

After taking the required regimen that satisfies the health care provider, a follow up appointment for an ultrasound will be made. The ultrasound will determine if the uterus has thinned and there are no more parts inside. If blood tests reveal that your HCG levels have decreased below 20 then you can try to conceive again. Most women have a menstrual cycle about 3-6 weeks later; however some women have reported having a period 3 months later.

 

References

American Pregnancy Association. D & C Procedure after a Miscarriage. (2011). Retrieved from: http://www.americanpregnancy.org/pregnancycomplications/dandc.html

Managing Complications in Pregnancy and Childbirth, World Health Organization Retrieved from: http://www.who.int/

 

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