Surgical Management of Retained Pregnancy
Date issued: May 2022
Review date: May 2024
Ref: B-423/KN/Maternity/Surgical management of retained pregnancy v3
PDF: Surgical management of retained pregnancy final May 2022 v3.pdf[pdf] 202KB
We hope this information is useful for you in preparing to come into hospital for your procedure.
Introduction
This leaflet is designed to guide you through the process.
On the day of the procedure
Please come to the Early Pregnancy Unit, Lancaster Suite, Level 6 on ….…………………………………
We suggest you bring some essentials (sanitary towels) but leave nonessentials at home.
Do I need to bring anyone with me?
It would be a good idea to bring your partner/ supportive friend or relative with you. They are welcome to come into the room with you during the procedure if that is what you want. Alternatively, they can wait in another room during this time. Most women find it comforting to have extra support and to take you home afterwards.
What happens when I arrive?
You will be seen by a nurse in EPU to check all the details you have already given are correct. Your blood pressure and temperature will be taken, and a name band applied. You will be seen by a doctor and asked to sign a consent form once all relevant information has been given. You will be given tablets to take (antibiotics and pain relief) about an hour before the procedure. Tablets called Misoprostol will be given vaginally to help soften the cervix (neck of the womb) to enable it to be dilated (stretched) during the procedure. You will also be given a suppository which is another type of pain relief.
What does the procedure involve?
You will be positioned on a gynaecology couch (the same as when you had your scan). A speculum is placed into the vagina and local anaesthetic in injected into the cervix (opening of the womb). The local anaesthetic does have a stinging sensation briefly. The cervix is then gently dilated (stretched) and the pregnancy tissue is removed using a handheld small suction device.
How long does it take?
The actual procedure takes about 5 minutes, but you will be in the room for about 20 minutes whilst we are getting you positioned correctly and giving the local anaesthetic. Occasionally the procedure can make you feel a little lightheaded and dizzy for a short while. If this happens you will need to stay lying down until this has passed. After the procedure another scan will be performed to ensure the womb is empty.
Will it hurt?
You will experience some period-like cramping during the procedure. This can sometimes be severe but only lasts for 1-2 minutes. You will have a nurse or health care assistant with you throughout and we can give you gas and air (Entonox) if necessary to help you at this time.
What are the risks?
This is a very safe procedure, but occasionally as with any operation there can be complications. These include infection, heavy bleeding and perforation (making a hole) of the womb. If this happened, it may be necessary to look into your tummy with a telescope and if there was internal bleeding an operation may be necessary to repair it.
Why do I need to have antibiotics?
When you have a procedure to remove pregnancy tissue, we routinely give antibiotics to reduce the risk of infection. The two antibiotics we use are both one-off doses. They are called Azithromycin and Metronidazole and are given an hour prior to the procedure.
Rhesus negative blood group
If you have a Rhesus (RhD) negative blood group, you may require an injection of Anti-D. This is to prevent a condition called Haemolytic Disease of the Newborn (HDN). It is very important for the safety of any future pregnancies to have this injection when advised.
When can I go home?
You can usually go home within an hour or so of the procedure, but this is flexible, and you may want to go home sooner or stay a little longer.
How long does the bleeding last?
Bleeding is variable and can last up to three weeks, but it should be light like the end of a period. Use sanitary pads and not tampons during this time. It is normal to experience some tummy cramps and even some small clots after the procedure but if:
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The bleeding becomes very heavy
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The pain becomes very severe
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You have an unpleasant smelling discharge
See your GP as you may need antibiotics
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. You can self-certificate for the first week off work, and thereafter you will need to see your GP if any further time off is needed.
When do I get my period again?
Every woman is different in regard to how soon they will have their next period. This can range from 3 to 6 weeks; 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 procedure, it may be advisable to contact your GP.
Please remember that nothing is too trivial to talk about.
If you are worried, we’d like to know.
Contact numbers
Early Pregnancy Unit (0800-17.30,
Monday –Friday) 01752 430887/ 245212
All other times:
Ocean Suite (Gynae ward) 01752 430026
