Medication for treating an incomplete miscarriage

If you have had an incomplete miscarriage with no complications, you may have the option of using medicine that causes the uterus to push out all remaining tissue. While medication treatment offers an alternative to surgical treatment, it can cause greater blood loss than surgical treatment, side effects can be severe, and it is not a well-researched practice.^{1, 2}

Mifepristone (RU 486) and misoprostol, medicines that are more commonly used to terminate first-trimester pregnancy, have been used on a limited basis to treat miscarriage. First, mifepristone acts to block the body's use of progesterone, a hormone that supports pregnancy. Then, misoprostol is used to soften the cervix and start uterine contractions, inducing the uterus to empty.

Misoprostol can be used alone to treat miscarriage.

Common side effects of mifepristone include:

• Abdominal pain.
• Nausea.
• Vomiting.
• Diarrhea.

Methylergonovine (Methergine), a medicine that makes blood vessels constrict throughout the body, is commonly used to control uterine bleeding after a miscarriage. Methergine makes the uterus contract, which helps control blood loss.

Citations

1. Geyman JP, et al. (1999). Expectant, medical, or surgical treatment of spontaneous abortion in first trimester of pregnancy? A pooled quantitative literature evaluation. Journal of the American Board of Family Practice, 12(1): 55–64.

2. Ankum WM, et al. (2001). Management of spontaneous miscarriage in the first trimester: An example of putting informed shared decision-making into practice. BMJ, 322(7298): 1343–1346.