Display Patient Information Leaflets

Evacuation of retained Products of Conception

Posted Thursday, 13 October 2022

Date issued: May 2022

Review date: May 2024

Ref B-351/KN/Gynae Evacuation of retained Products of Conception v5

PDF: Evacuation of retained products of conception final May 2022 v5.pdf[pdf] 255KB

We are very sorry you have had a miscarriage. We hope this information is useful for you in preparing to come into hospital for your procedure.

Please report to: ___________________ at 07.00

On ______________________

Please ensure you have had nothing to eat or drink from midnight. This will reduce your risk of vomiting or regurgitating food whilst you are under anaesthetic.
You may be given a prescription for some pessaries (vaginal tablets) to give to yourself prior to admission. These soften the cervix (neck of the womb) and makes it easier to open during the procedure.
Bring a dressing gown and slippers and suitable underwear so that you can wear a sanitary towel.
Do not wear make-up, nail varnish or jewellery (Except a wedding ring).
Please do not bring valuables into hospital.

Note: you should arrange for a responsible adult to accompany you home and to remain with you overnight.

What is Surgical management of miscarriage?

Surgical management of miscarriage involves removing any parts of your pregnancy that may remain in your womb following a miscarriage.

What happens?

On your admission, the person with you will be given a telephone number and advised an approximate time to phone and arrange to collect you. However, someone may stay with you on the pre-operative ward until you go to theatre. When you have left the ward, they are welcome to stay on that ward if they wish until you are ready to go home.

Please note you will be cared for post operatively on another ward and visitors are not allowed until you are nearly ready for discharge.

Before your operation the doctors will explain the procedure to you including the risks.

You will be given a light general anaesthetic.

The operation is performed through the cervix (neck of the womb).

The procedure takes 5-10 minutes.

Possible risks or complications

The risks of the operation are made as small as possible by operating in a sterile environment and giving you antibiotics afterwards.

The most common problems are:

Bleeding
Subsequent infection in the uterus (womb)
Damage to the cervix or the uterus.
Very rarely, an operation may be required if there is any damage to the uterus.
There is a rare chance that some of the retained tissue is missed and you will require a further operation to remove it.
Your gynaecologist and nurse will ensure that appropriate measures are taken to reduce the risk of complications.

What happens after my surgery?

When you return to the ward you will still be feeling sleepy, but physically well, although you may experience some abdominal cramping.

You may have a ‘drip’ or cannula (venflon) in place. This will be removed when you have had a drink, some biscuits or a sandwich and have passed urine.

If you are a Rhesus negative blood group you will require an injection of anti-D prior to discharge.

Once you are fully recovered, you are usually able to go home, after about two hours.

You will be given a course of antibiotics to take for 1 week to reduce the risk of infection (please complete the course!).

Don’t forget: you should arrange for someone to stay with you for the first 24 hours after the operation.

Post anaesthetic information

Some side effects may occur in the first 24 hours following the general anaesthetic.

They include:

Headache
Dizziness
Nausea (a feeling of sickness)
Drowsiness
A dry or sore throat.

Therefore, even if you feel perfectly well DO NOT:

Drive a motor vehicle, motor cycle or bicycle. You may not be covered by you insurance.
Drink alcohol
Return to work
Do any cooking (risk of scalding etc.)
Use electrical tools
Sign any important documents.

You can eat and drink normally after discharge from hospital.

What to expect

You may bleed after the operation, but the amount varies from person to person. It may last up to three weeks (perhaps on and off) just like a period and usually turns a brownish colour.
Provided that you do not bleed very heavily with bright red blood, do not worry.
You may get cramp like pains for a few days. A simple pain killer such as one you would normally take for a headache should relieve this.

To help avoid getting an infection during this time:

Use sanitary towels rather than tampons.
Avoid sexual intercourse for two weeks after the operation.
You may have baths or showers as normal.

What symptoms should I be worried about?

If you develop any of the following symptoms please see your own doctor immediately:

Severe or continuous pain.
Heavy bright red vaginal, or prolonged bleeding
A high temperature
Feel generally unwell, have flu like symptoms or a smelly vaginal discharge
Feel faint
If you notice a red inflamed patch on either breast.

What happens to the baby?

All pregnancies are treated sensitively and with the utmost respect in accordance with the choices of the mother. You will be given information about the choices available and can discuss this with the nurse looking after you.

When can I resume normal activities?

Avoid intercourse until at least a week after the bleeding has stopped. Baths and showers after the procedure are fine but no swimming until the bleeding has stopped. Physically you should be well enough to return to work after a few days but some women need extra time off to recover and adjust to the loss of the baby. The loss of a baby can be a very distressing event in a woman’s life. You can self-certificate for the first week off work, and thereafter you will need to see your GP to be provided with a sick certificate. Women who work in the home also need support from partners, family or friends at this difficult time.

There are some useful websites and contacts at the end of this leaflet if you need extra support.

When do I get my period again?

Every woman is different in regard to how soon, after they miscarry, they will have their next period. This can range from 3 to 6 weeks. Remember that this can vary as you are experiencing a loss of a pregnancy, not a period, and the body and your hormones can take time to return to normal. Often the next period can be different than that which you normally experience (heavier or lighter, again this is nothing to be concerned about, unless the bleeding is very heavy and prolonged, in which case consult with your GP)

If you do not have a period, within 6 weeks of your miscarriage, it may be advisable to contact your GP.

The future

Whether you decide that you wish to try for another baby is an extremely personal decision that only you and your partner can decide.

Should you feel that at some time you may be ready to try again it is recommend that you take daily folic acid (preferably for 3 months before a pregnancy) and wait for at least one period following a miscarriage before trying for another baby. Once you have had a period then we know that your hormones are back to normal and you are fit and healthy for the next pregnancy.