Surgical Management of Miscarriage

Surgical management of miscarriage is a procedure to remove pregnancy tissue from the uterus after a miscarriage. It is typically recommended if:

• Your body has not passed the pregnancy tissue naturally (incomplete miscarriage).
• There are signs of infection or heavy bleeding.
• You prefer a quicker resolution rather than waiting for natural or medical management.

Why is it Performed?

Your gynaecologist may recommend this procedure to:

• Prevent complications (e.g., infection, prolonged bleeding).
• Provide closure and physical recovery.
• Allow for testing of the tissue (if recurrent miscarriages or concerns).

Before the Procedure

• Consultation: Discuss your options, risks, and emotional needs with your gynaecologist.
• Pre-operative checks:
  • Ultrasound to confirm the miscarriage.
  • Blood tests (e.g., to check for anaemia or infection).
• Preparation:
  
  • Fasting: No food/drink for 6–8 hours before the procedure (if under general anaesthesia).
  • Arrange support: Someone must drive you home and stay with you post-procedure.
  • Emotional preparation: This can be a difficult experience – ask about counselling or support services.

During the Procedure

• Anaesthesia: Usually under general anaesthesia (asleep) or local anaesthesia with sedation.
• Process:
  
  • The cervix is gently dilated (opened).Pregnancy tissue is removed using suction or a small instrument.
  • The procedure takes 10–20 minutes.
• Recovery: You’ll be monitored until awake and stable (1–2 hours).

What you might feel:

• Cramping or light bleeding afterward.

Risks and Complications

• Common (temporary):
  • Mild to moderate cramping and bleeding (similar to a period) for 1–2 weeks.
  • Emotional distress or grief.
• Rare but serious:
  
  • Infection (symptoms: fever, foul-smelling discharge, severe pain).
  • Heavy bleeding (soaking >2 pads/hour for 2+ hours).
  • Uterine perforation (very rare; may require further treatment).
  • Scarring (Asherman’s syndrome – rare, can affect future fertility).

Recovery and Aftercare

• Physical recovery:
  • Rest for 24–48 hours; avoid strenuous activity for 1–2 weeks. Use sanitary pads (not tampons) until bleeding stops.
  • Take pain relief (e.g., paracetamol) as needed.
• Emotional recovery:
  
  • Grief, sadness, or anger are normal. Seek support from loved ones or professionals.
• Follow-up:
  • A check-up in 2–4 weeks to ensure recovery.
  • Discuss contraception or future pregnancy plans with your gynaecologist.