שיטות הטיפול בהפלה נדחית/בלתי שלמה בשליש הראשון להריון (אנגלית)

Treatment options for a delayed miscarriage/non-viable pregnancy during the first trimester in the Obstetrics & Gynecology Department of Hadassah Mount Scopus

 

Dear Patient,
As it has unfortunately been found on examination that your pregnancy is non-viable and the fetus is no longer developing, we offer our condolences on your loss and hope that this will not happen again.
For your benefit, we have prepared an information sheet about the possible procedures you may undergo.
We are at your service for any questions,
The Staff of the Department

General Information
The procedures are carried out in the Surgical Day Care Clinic:
Location: 1st floor
Telephone: 02-5844671
Fax: 02-5844861

As long as you show no signs of fever, severe stomach pain or heavy vaginal bleeding, this is not an emergency situation requiring urgent intervention, and therefore the procedures detailed below are not carried out in the Emergency Room.
In order to allow the uterus to return to normal functioning it needs to be cleared out.

What procedures are available for clearing out the uterus?

  • Waiting, without any treatment, until the miscarriage happens on its own.
  • Clearing out the uterus by curettage (D&C) or suction.
  • Administering medication which causes the uterus to contract and expel the pregnancy.

According to cumulative world experience, the chances of successfully clearing out the uterus are about 40% for the waiting method, 85% for the medication method and 100% for D&C. If waiting or medication fail then D&C has to be carried out.
The waiting method entails a relatively long period (up to a month) of bleeding and sometimes pain, and the chances of success are low.
Following are details of the medication process with Cytotec (Misoprostol) and the D&C procedure as they are carried out in the Obstetrics & Gynecology Department of Hadassah Mount Scopus.

 

Dilation & Curretage / D
The D&C method is the most efficient. The procedure is carried out in the operating room under general anesthetic, in the framework of the surgical daycare department, on Wednesday afternoons from 15.00. The procedure takes about half an hour and is usually over by 19.00.
To schedule an appointment for a D&C call 02-5845444.
After scheduling the appointment you will be requested to come to the Surgical Daycare Department, at 10.30 on the morning of the procedure, while fasting.

What to Bring?

  • An up to date blood count
  • An obligation of payment from your health fund

    After being admitted to the daycare department you will undergo an ultrasound and examination by a doctor in the Obstetrics & Gynecology Department.
    During the doctor's examination an intravenous needle will be inserted and a blood sample taken. Also, several tablets of Cytotec will be inserted into the vagina in order to widen the cervix before beginning the procedure.
    After the procedure you will remain under observation for 2 to 3 hours and if all is in order you will then be discharged.

The medication method of clearing out the uterus without the use of instruments
Cytotec is a medication which causes contraction of the uterus, opening of the cervix and finally expulsion of the pregnancy.
Treatment with this medication involves side effects such as bleeding for several days, up to 2 weeks, and the initial bleeding is a little heavier than a normal period. In most cases the bleeding is accompanied by pain in the lower abdomen, and maybe also by vomiting and diarrhea.
The treatment is carried out on Sunday to Thursday in the Surgical Daycare Department.

To schedule a treatment with Cytotec call the Surgical Daycare Department 02-5844642/71.


You should come to the Surgical Daycare Department at 8.00 am on the day scheduled for treatment.

What to Bring?

  • An up to date blood count
  • Blood type
  • An obligation of payment from your health fund

After admittance to the Daycare Department you will be sent for an ultrasound and examination by a doctor in the Obstetrics & Gynecology Department.
On your return to the Daycare Department you will be given 4 tablets of Cytotec. You have to place the tablets between your cheek and jaw and keep them there until they dissolve. After this you will remain in the department for 2 hours for monitoring. If all is in order, you will then be sent home.
An appointment will be scheduled for 2 days later in the ultrasound unit and you will be examined there by a doctor. If there are still signs of pregnancy in the uterus (which happens in most cases) you will be administered 4 more tablets of Cytotec. You will then be discharged with instructions for a further ultrasound examination in your health fund clinic, after your next period.

For any further questions please call the Obstetrics & Gynecology Clinic: 02-5844953


Wishing you a speedy recovery, The Staff of the Obstetrics & Gynecology Department, Hadassah Mount Scopus