miscarriage

[havo]

I discovered i was pregnant on 21st January 2008. I had had some bron staining in decemeber but the 1st day off my last period was 26th Novemeber. I booked an appointment with my local midwife and she tried to hear a heart beat but she could when i went to the hospital for an enternal scan they measured the baby at 3.6mm but still couldn't hear or see a heart beat. I then was told to come back a week  later and they informed me there has been no growth and now i have been given the options off what to do for the miscarriage. I am obviously quite frightened as this is my first pregnancy and i am not sure what to do. I have had no bleeding and can't understand how tey just assume i am going to misscarry.

[zoeb2]

I spontaneously miscarried and was placed on methergine for 3 days.  I had a period 45 days later ( in Nov 07) and have not had one since.  I have also taken 3 hpt which have all been negative.  Is there a chance that my miscarriage is incomplete?

[Keith Downing, MD]

Hello,

Your providers have confirmed a failed pregnancy, my condolensces to you.  I would have you confirm with them upon what grounds they have made this diagnosis.  Typically it is a large empty sac, or a fetal pole (early embryo) with no fetal heart activity.  

At such an early gestation you have three options.  1) Expectant management: most failed pregnancy spontaneously abort in 2 weeks.  That said, there is a small risk of incomplete abortion.
2) Misoprostol induction: this is medication (tablets) usually placed vaginal that causes uterine contractions and thus induces an abortion.  Again, there is small risk of incomplete abortion (i.e., retained tissue)

3) Dilation and evacuation: this is a minor surgical procedure to empty the uterus of the pregnancy tissue.  This would result in the lowest likelihood of retained tissue, however, there are the risks of the procedure that must be considered (although overall, very safe).

You can discuss these issues with your ob/gyn.

Best regards,

Dr. Downing