טיפול תרופתי בציטוטק (Misoprostol) בהפלה נדחית / בלתי - שלמה בשליש הראשון להריון (אנגלית)

Use of the medication Cytotec (Misoprostol) for delayed / incomplete miscarriage during the 1st trimester of pregnancy

Dear Patient,
You have been examined and it has unfortunately been discovered that your pregnancy is not viable and the fetus is no longer developing. It is necessary to clear out your uterus so that it can return to functioning properly.
For your benefit we have prepared an information sheet describing the procedure.

We are here to answer any questions,
The Team of the Department

 

General Information
Treatment is carried out Sunday – Thursday in the Surgical Outpatient Department:
Location: 1st floor
Telephone: 02-5844671
Fax: 02-5844861


 

Medical Termination of Pregnancy
If you have decided, together with your doctor, that you want to terminate your pregnancy with medication you should know some facts about the procedure.
The treatment is carried out in the Surgical Outpatient Department. Your stay will be short (about 3 hours) and usually there is no need to be admitted overnight.
After you have been admitted and had the procedure explained to you by the nurse, you will have an ultrasound and be examined by a gynecologist. Then you will be given 4 tablets of Cytotec. Each tablet of Cytotec contains 200 micrograms of a substance called prostaglandin E1, which causes the uterus to contract and the cervix to dilate, resulting in expulsion of the fetal tissue.
Place the tablets in your mouth between the cheek and the jaw. The tablets will dissolve in about an hour. You need to stay in the department after taking the tablets to ensure that there is no severe reaction to the medication such as shivering, fever, nausea or diarrhea. During the first few hours after the treatment there may be uterine contractions, vaginal bleeding and maybe even some discharge of fetal tissue. In most cases this discharge is expelled during the first 24 hours.
After monitoring you will be allowed to go home.

At home, if one or more of the following symptoms appears, you must immediately return to the Emergency Room for a checkup and assessment of the situation:

  • Severe vaginal bleeding
  • Temperature over 38.5°C
  • Severe vomiting and diarrhea

If no serious side effects appear you should return to the Daycare Department after 2 days to have an ultrasound (on the 6th floor) and a gynecological examination (in the Outpatient Building). If the treatment is found to have worked and the uterus is clear, you will return to the Daycare Department and the nurse will release you and send you home.
If the uterus has not been completely cleared out and some signs of pregnancy still remain (as happens in many cases), you will be administered 4 more tablets of Cytotec. After the treatment you will need to remain in the department for only an hour. You will be referred to your health clinic for an ultrasound, and depending on the result, for a gynecological examination following your next period. If the ultrasound shows that the uterus is still not completely cleared out, you will be referred for surgical D&C.



After release from hospital:

  • It is advisable to rest for 3 days at home before returning to your usual routine.
  • Bleeding and/or discharge may continue for 2 weeks after the intervention.
  • There is no restriction on showering but do not go into the sea or swimming pool for 2 weeks.
  • Avoid sexual relations for 2 weeks.
  • If you do not want to become pregnant again you need to use a contraceptive.
  • You should get your period a month to 6 weeks after the uterus has been cleared out.
  • You may treat pain with pain killers:
    1 gram of Acamol every 6 hours and/or 1 gram of Optalgin every 6 hours and/or 400 milligrams of Ibufen every 8 hours (these drugs may be taken in combination and taking one of them is not dependent on having taken another).
  • During the first weeks after the miscarriage you may experience periods of depression and weeping. These are normal reactions and should pass.

Consult the doctor treating you or go to the Emergency Room if any of the following appear:

  • Temperature over 38.5° (measured twice with a 2 hour interval between measurements and without taking any fever reducing medication).
  • Severe pain which is not eliminated with pain killers or an increase in the level of pain.
  • Heavy vaginal bleeding.
  • Schedule an appointment with a gynecologist after a month.

For any questions that may arise after your release you may phone the Obstetrics & Gynecology Clinic : 02-5844953

Wishing you a speedy recovery
The Staff of the Outpatient Clinic - Hadassah Mount Scopus

 

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