Medical management of miscarriage



Key content

  • Miscarriage is a common event in women of reproductive age, with an incidence of 10–20%.
  • Traditionally, surgical evacuation of the uterus was the gold standard for the management of miscarriage.
  • Medical management of miscarriage using a suitable prostaglandin analogue is a safe and effective alternative with high efficacy and patient acceptability.
  • Medical management can be routinely offered as an alternative option, thereby increasing women's choice.

Learning objectives

  • To understand the indications, efficacy and adverse effects of medical treatment.
  • To learn about the various treatment regimens of medical management for different types of miscarriage at varying gestations.
  • To understand the need for analgesia and psychological support during treatment.

Ethical issues

  • Prescribing misoprostol for unlicensed indication: where do we stand?
  • Can medical management be offered to women where geographical barriers exist?
  • Given the analgesia requirement and psychological sequelae associated with pregnancy loss, is medical management at home a feasible option?