Cytotec miscarriage how long to work

If you have been told that you have been prescribed both medicines, you will be given mifepristone first. Mifepristone is sometimes given before misoprostol as the combination of the medicines will work together to complete the miscarriage. Misoprostol is a medicine which allows the cervix the entrance of the womb to open and causes the uterus to cramp so the pregnancy will pass. If the pregnancy is less than 10 weeks, you can take these tablets home with you, so you can be in the comfort of your own surroundings to miscarry.

If the pregnancy is over 10 weeks you will need to come into a BPAS centre to receive the medication and to be monitored until the pregnancy has passed. This may mean an overnight stay so bring the items you will need.

If you choose to take the tablets by mouth you will be given 3 tablets. You will need to place the tablets under your tongue and leave them in place to dissolve for 30 minutes. You may then need to swallow the remainder of any pills.

If you choose to have the tablets placed in your vagina you will be given 4 tablets. You can place them in the vagina or if you prefer your healthcare professional can insert them for you. If your blood group is Rhesus-negative you will also have an Anti-D injection. However you choose to take the misoprostol tablets they will cause you to have cramps and bleeding.

This usually starts about 2 hours after you have taken the tablets but can start sooner. The cramping is usually worse than period cramps and is bad enough that you will need pain medication. We will give you pain control medicine and also instructions on how to take medicines you can buy at the pharmacy. If this treatment has not worked you may be advised to have a surgical treatment to complete the miscarriage.

A nurse will be in attendance and your progress will be monitored. You can rest in bed or be up and about as you wish. The misoprostol will be repeated every 3 hours until the miscarriage is complete. Many women will only require 1 or 2 doses of the misoprostol to enable the pregnancy to be passed.

You may see large blood clots or the pregnancy but the nurse will try to make sure that you see very little, however, sometimes this is not possible as events can be rapid. Sometimes the placenta does not come out at the same time as the pregnancy. In this case, you may need more misoprostol or need to be taken to the operating theatre. On rare occasions you will need to be transferred to a local NHS hospital for further treatment. You will not need a follow up appointment if you have had medical miscarriage management at a BPAS clinic.

During a medical procedure, most women will have strong cramping, similar to period pains. There are many ways to lessen the pain:. Once the cramping and bleeding begins you may see large blood clots of tissue as the pregnancy passes and you will probably need pain medication. Most women pass the pregnancy within 4 hours after taking the medication. For pain management of abdominal cramping, over-the-counter ibuprofen or other NSAIDs should be recommended, provided that the patient does not have contraindications for their use.

With miscarriage being such an emotional time, patients may not have a clear understanding of why the remnants of the pregnancy need to be evacuated or know the more severe adverse events of miscarriage to watch out for, including infection and hemorrhage. Patients with miscarriages are at risk for infections due to dilation of the cervix. Antibiotic prescriptions are more commonly prescribed for patients with postsurgical abortion, although they may also be prescribed to miscarriage patients taking misoprostol.

Hemorrhage is also a concern with miscarriages. It can be a result of damage to the reproductive organs or coagulopathy. As the patient passes the contents of the uterus, vaginal bleeding will occur.

If the patient experiences abnormally heavy and prolonged bleeding, she should contact her obstetrician immediately. After receiving counseling on more severe adverse events of miscarriage, patients may be concerned, and their concerns must be addressed. Patients need to know to monitor for these signs and symptoms to reduce the risk for complications through early detection. Interaction with a pharmacist can positively impact the emotional outcomes of a patient with a miscarriage.

Psychological outcomes improve if the emotional issues are discussed. She may be blaming herself for the miscarriage, due to the misconceptions that stress, exercise, or sexual activity could lead to early pregnancy loss.

Forums can be helpful resources for women to read about other miscarriage stories, and possibly share their own experiences. Examples of forums that can be recommended can be found in Table 2. October is National Miscarriage Awareness month; there are many events held during this time for a woman and her family to remember their lost child.

The annual Wave of Light is on October 15 at 7 pm in your time zone; participants can light a candle for at least 1 hour to honor those lost to miscarriage, stillbirth, or neonate death. It is important to clarify that misoprostol will have no impact on future fertility. Recommendations may vary among physicians and should be individualized per patient. In addition, patients who are emotionally unstable may not be psychologically prepared to become pregnant soon after their miscarriage. In these patients, contraception options should be discussed and put into practice to prevent a possible unwanted pregnancy.

The use and compliance of contraception is higher in patients who are counseled on its importance at the initiation of misoprostol treatment. When a prescription for misoprostol is brought into your pharmacy, it can be for either an elective abortion or a spontaneous miscarriage.

The terms abortion and miscarriage may be used interchangeably, so communication is necessary to understand why the patient is taking misoprostol. These interactions should begin with providing comforting words to the patient, and transition into the use of misoprostol and encouraging discussion about miscarriage.

By following these best practices, pharmacists will be able to make a difference in the emotional well-being of patients receiving misoprostol for a miscarriage. I have always appreciated—frankly, always expected—that my pharmacist asked whether I had any questions about the medications I was taking.

Unfortunately, in a time when I needed it most, it was not offered. Going through a miscarriage is a significant emotional rollercoaster. The physician prescribed medication to manage my missed abortion, including pain medication, antibiotics, and misoprostol. When my doctor explained what was happening, I was so overwhelmed with emotion that I was not paying much attention, much less asking any questions. I dropped off my prescription at the pharmacy shortly after the appointment.

I had been crying in the car before I arrived, and I am sure I looked visibly upset. After a short while, I went back to pick up the medications, including misoprostol. I was never asked if I had any questions about the medication or if I needed to speak with the pharmacist in a more private area.

Instead, I felt like I was being judged for picking up the misoprostol—as if it was my decision to end my pregnancy. Patients may take OTC acetaminophen to help manage the pain or prescription pain medication eg, acetaminophen with codeine , along with the misoprostol may be used. It is important for patients not to take both OTC and prescription pain medication to avoid exceeding the daily recommended dose of acetaminophen.

Women who are Rh D negative should receive Rh D -immune globulin within 72 hours of the first misoprostol administration. Follow-up is important after misoprostol administration. Advise patients to follow up with their OB-GYN within 7 to 14 days for an ultrasound to ensure the complete passage of tissue. December 8, Early pregnancy loss. Published May Accessed November 28, Mayo Clinic. Related Content: Retail.