Misoprostol for Treatment of Early Pregnancy Loss
A missed abortion refers to a fetus that is no longer living but the tissue of the fetus has not come
out from the uterus. This is in 15 to 20% of all pregnancies. It happens more often in
pregnancies that are 13 weeks or less. The reasons for it are unclear.
Waiting for fetal tissue and uterine lining to pass on its own
Surgery to remove tissue (D&C or manual vacuum aspiration)
Treatment with the drug misoprostol
How is misoprostol given?
Four tablets are placed in the vagina. Misoprostol will loosen fetal tissue and uterine lining. The
uterus will contract and dilate the cervix within a couple of hours. It will take about 4-16 hours
to pass the tissue. Sometimes, a second dose is needed if the tissue is not passed within 24 hours.
You will have vaginal bleeding likely heavier than a period for 3 to 7 days after your treatment.
Bleeding may vary from heavy with some clots to only slight spotting. Spotting may go on for
over 2 weeks.
You may have severe cramping for up to a week after the tissue has passed. A heating
pad and pain medicine (Advil , Aleve , Motrin ) can be used to help. If cramping is so
severe that you can’t do your daily routine, please call. Your physician can also provide
a stronger medicine if needed.
Eat lightly for the first 12 to 24 hours. Nausea and some vomiting are common.
Your next period should be 4 to 6 weeks after the miscarriage. If you do not get your
period, please call.
No intercourse or use of tampons for 2 weeks. You can still get pregnant shortly after
miscarriage. Severe infection may occur from intercourse.
You should feel well enough to go back to your normal routine within 48 to 72 hours.
Intense activities such as horseback riding, jogging, and heavy exercise may increase
bleeding and cramping.
Symptoms of pregnancy (i.e. breast tenderness, nausea) should go away within a week.
If breasts become full or leak, wear a tight bra night and day. Less breast stimulation will
Feelings after miscarriage can range from the blues to depression. The milder forms are
more common. If you need support, there is help. Please call your midwife, or doctor.
We have a trained counselor in our clinic they can refer you to. Seeking help is the best
thing you can do if you are having trouble handling these feelings on your own.
When to call
Temperature over 101 θ F
Prolonged heavy bleeding (soaking more than one pad per hour for greater than 2 hours)
Severe lower stomach pain
Generations Fertility Care (608) 824-6160
Mon-Fri., 7 am to 4:30 pm
Sat-Sun., 7 am to 11 am
After hours and on holidays, this number reaches the Health Line. A RN will triage your phone
calls and a doctor can be paged if needed.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright 1/2015. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing HF#6077