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

1. Anaesthesia: Usually under general anaesthesia (asleep) or local anaesthesia with sedation.
2. Process:
   1. The cervix is gently dilated (opened).
   1. Pregnancy tissue is removed using suction or a small instrument.
   1. The procedure takes 10–20 minutes.
3. 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.

Frequently Asked Questions

Q: Will this affect my chances of future pregnancies?
A: No – surgical management rarely impacts fertility. Most women go on to have healthy pregnancies.

Q: How soon can I try to conceive again?
A: Your gynaecologist may advise waiting 1–3 menstrual cycles for emotional and physical recovery.

Q: Can I see the pregnancy tissue for testing?
A: Testing is optional but can help identify causes of recurrent miscarriage. Discuss with your provider.

Q: Is it normal to feel guilt or sadness?
A: Yes. Miscarriage is not your fault. Counselling or support groups can help (see below).

eGynaecologist Advice:

• You must seek urgent gynaecological advice if you developheavy bleeding, raised temperature >38°C, or severe pelvic pain following SMM procedure

You may discuss chromosome analysis of products of pregnancy with your gynaecologist if you have suffered recurrent miscarriages.