Pregnancy loss, commonly known as miscarriage is faced by millions of women around the world. There are no definite reasons why it can occur. Miscarriage happens when a pregnancy stops growing and is generally diagnosed through symptoms of bleeding in early pregnancy or routine tests. Contrary to common notions, loss of pregnancy does not happen due to stress or taking part in specific activities like sports or sex.
Most women will consult doctors and be present at a hospital or health care facility when experience early signs of a miscarriage and before progressing to a complete miscarriage. After check-up and medical assessment and tests, she will be discharged home if there are no complications; else she will be advised hospitalisation.
Doctors generally resort to pregnancy loss management in 3 ways.
This constitutes the bulk of miscarriage management, almost to half of total number treated. It means waiting for the natural loss of pregnancy to occur. This can take some time to happen after the early warning signals of bleeding and pain. In this wait and watch scenario, cramping and bleeding can start any time. Heavy bleeding can last anywhere between three to five hours and is not considered to be dangerous. Lighter bleeding can go on for even two weeks and will start and stop a few times. Heating pads and a painkiller such as Ibuprofen can help ease the discomfort.
Specially prescribed medication is used in this case as a treatment option. Success rate is as high as 80 to 90 percent and is resorted to when the loss of pregnancy occurs within the first 28 weeks. Medication is given to open the cervix and pass the pregnancy tissue comprising of placenta, pregnancy membranes and the developing baby. The process of induced miscarriage starts about a few hours after medication and can lead to pain, bleeding and clotting. This can even go on for 4 weeks. If the pregnancy is within 12 weeks, follow up care may be taken from home, beyond that the patient is admitted to hospital.
In the hospital trained nurses who have specialised in pregnancy loss care and have gone through hands-on practically oriented courses are usually assigned to this department. An example is the nurses who have completed nursing programmes from the Australian Centre of Further Education, a reputed Institute in Australia offering diploma and advanced courses in nursing.
Some women experience nausea, chills or diarrhoea after medicine Misoprostol is given to induce loss of pregnancy. Using heating pads and Ibuprofen helps to minimise the side effects. There is no need to get distressed due to heavy bleeding as it just goes to show that the medication is working.
This is carried out under general anaesthesia and involves a surgical procedure called D&C (dilation and curettage). Pregnancy tissue is removed from the uterus and apart from the small surgical risks associated with any surgery, the success rate is 95 to 100 percent. Surgical management is an option only in the first 12 weeks of pregnancy.
The procedure is often done under local anaesthesia too. Pain medication is first given to ease cramps after which local anaesthesia is injected around the cervix or opening of the uterus. The cervix is then gently stretched and the pregnancy tissue is removed with surgical tools. The whole process takes about 10 minutes only and the patient is discharged after an hour of rest. She can resume her normal routine the next day.
Here too, hospitals and health care centres deploy specially trained nurses for optimised patient care. For more information on their learning schedule, visit http://acfe.edu.au/courses/diploma-of-nursing/.
What then should be the preferred option for women? The first is obviously to wait and watch and if that takes too long, to take the medication route. As a last resort the surgical method can be chosen and that works 100% for any type of miscarriage.