Surgical management of miscarriage

Surgical management of miscarriage

Following a diagnosis of miscarriage, you will be able to discuss the management options available to you. In some circumstances, surgical management may be recommended and is sometimes performed as an emergency procedure, for example if a woman is experiencing heavy bleeding due to a natural miscarriage.

The process of surgical management of miscarriage involves gently opening the cervix (neck of the womb) and removing the pregnancy from within the uterus (womb). There are some risks associated with this procedure but overall it is rare to have a major complication.

Before your operation

You will be booked to have your procedure on either a morning or afternoon operating list. We will not be able to give you the exact time of your operation as the order of the list is not set beforehand and will depend on various circumstances on the day.

Most women will have their operation in the Treatment Centre which is located on the ground floor close to lift bank B. Unfortunately, the unit is not able to accommodate partners or relatives, although there is a waiting area available.

Prior to your operation you will see a member of the gynaecology team who will discuss the procedure with you, explain possible complications and ask about your medical history. You will be asked to sign a consent form which is used to confirm you have understood the operation and the potential complications. You may be asked to have a blood test to determine your blood group and haemoglobin level. 

A small number of women will have a natural miscarriage prior to their planned procedure. If you have significant bleeding before the operation, please contact the unit.

Some women may need a repeat scan to determine if the surgery is still required. If the bleeding becomes very heavy, you should attend as an emergency via the  A&E department.

On the day of your operation

Surgical management usually involves having a general anaesthetic which means you will be asleep whilst the operation is performed. Depending on individual circumstances, some women will be given the option of having the procedure under local anaesthetic. This means you are awake and receive a series of injections to numb the cervix (neck of the womb) prior to the procedure.

Prior to a general anaesthetic you should be fasted (have not eaten) for a minimum period of 6 hours before to ensure your stomach is completely empty. If you are not fully fasted your procedure may need to be delayed to avoid potential complications of the anaesthetic.

If you are booked on a morning list, you should not eat or drink from midnight before (12am) on the day of surgery. You can eat and drink as normal before midnight. Please attend the Treatment Centre at 7.30am.

If you are booked on an afternoon list, you may have a light breakfast before 6am on the day of the operation but nothing to eat after this time. You can drink water up until 10am (water only 6am–10am). Please attend the Treatment Centre at 1200.

Whilst you are fasting please do not have chewing gum or smoke cigarettes (including vapour devices/e- cigarettes). If you take medication for pre-existing medical problems, take this as normal on the morning of your operation with a sip of water. 

Please discuss this with the doctor you see prior to the surgery as there are a few medications that need to be stopped temporarily.

Before the operation you will be given four small tablets called Misoprostol. These tablets are inserted into the vagina prior to the operation to help soften the cervix ready for the procedure. The tablets should be inserted into the vagina in a similar way to a tampon.

If you are booked onto a morning list, please insert the tablets at 7am. If you are on an afternoon list, please insert the tablets at 11:30am.