What does medical management of miscarriage treat?

After a miscarriage, some pregnancy tissue may remain in the uterus. Medicine encourages the uterus to contract and pass this tissue through the vagina. Misoprostol is commonly used for this purpose. The treatment is intended for a miscarriage that has already been assessed; it does not end an ongoing healthy pregnancy.

Cramping and vaginal bleeding are expected as the uterus responds. Bleeding can be heavier than a period for a while, followed by lighter bleeding or spotting. Nausea, diarrhoea, chills or a temporary raised temperature can also occur. Your clinician may arrange follow-up to check that the uterus has emptied and to discuss another option if tissue remains.

Use the medicine exactly as prescribed and plan to rest near a bathroom while the strongest cramps and bleeding occur. Keep sanitary pads available so you can observe the bleeding; avoid inserting anything into the vagina until your clinician says it is appropriate. Fluids, gentle food and a heating pad may make the experience easier.

Contact the service caring for you if bleeding or pain is not settling, or if you are unsure whether the treatment has worked. Medical and surgical management are different approaches, and the suitable choice depends on your symptoms, examination and scan findings.

Seek urgent medical help for bleeding that rapidly soaks pads, severe or worsening abdominal pain, fainting, marked dizziness, difficulty breathing, or feeling very unwell. Contact a clinician promptly for a fever that persists, foul-smelling discharge or pain that is increasing rather than easing, as these can signal infection or tissue remaining in the uterus.

Ask which medicine to use, when bleeding and cramps should begin, how follow-up will confirm completion, what pain relief is suitable for you, and what to do if the treatment does not empty the uterus.