Retained pregnancy tissue: treatment with Misoprostol tablets
Information for women, birthing people, and their families
This information leaflet aims to help explain the treatment of retained products of conception (pregnancy tissue), using a medication called Misoprostol. If after reading this leaflet you have any questions, please speak to your doctor or specialist nurse.
What are retained products of conception?
Your recent ultrasound has shown some remaining pregnancy tissue in your womb. The Misoprostol tablets will hopefully help your body to pass this tissue quickly.
Are there alternatives to taking Misoprostol?
Yes. Instead of taking Misoprostol you may be able to:
do nothing, and wait for your body to pass the tissue on its own; or
have the tissue removed with surgery; whether surgery is an option will depend on the amount of remaining pregnancy tissue there is.
If suitable, your doctor or nurse will discuss these alternative treatments with you before any decisions about treatment are made.
What is Misoprostol?
Misoprostol is a medication that works by softening your cervix (neck of the womb), causing your uterus (womb) to contract and expel the pregnancy tissue.
We need to tell you that although Misoprostol has been used for this purpose for a long time, it is not licensed for this use. If you wish to discuss this further, please speak to your consultant.
What are the benefits of using Misoprostol?
There is no need to stay in hospital after you have taken the medication.
Most patients avoid having surgery and a general anaesthetic.
The risk of infection is low.
Using Misoprostol is successful in approximately eight out of 10 cases.
How do I take the Misoprostol tablets?
You will be given the tablets to take at home. You can take the tablets by mouth, or it can be put under your tongue for a few minutes before swallowing. It can also be inserted in your vagina. Which method is best for you will be discussed with your doctor or specialist nurse before you are given the tablets.
What should I expect after using Misoprostol?
You may feel some period type pains, these may be worse than your normal period pains. If this happens, you can take paracetamol, ibuprofen, co-codamol, or your usual pain relief. Follow the instructions on the packet for the pain relief you choose. Usually intense pain does not last for long.
Your bleeding may increase slightly but should not be excessive. We would expect your pain and bleeding to settle completely in two to three weeks.
It is important that you contact the Early Pregnancy Assessment Unit (EPAU) or gynaecology ward if you are worried about your symptoms or you experience any of the following.
Heavy bleeding with clots.
Severe tummy pain or discomfort that is not eased by simple pain relief medication, such as paracetamol.
Bad smelling vaginal discharge.
What are the side effects?
Like all medicines, Misoprostol can cause some side effects, but not everyone gets them. Chills, nausea (feeling sick), diarrhoea, and cramps are the most common, but do not happen very often, are not serious, and will wear off after a while. If you are worried about any of the side effects, please contact the EPAU or gynaecology ward.
What will happen next?
You can expect to have some vaginal bleeding for two to three weeks after you take the tablets. This should lessen and may become brown in colour during this time.
During this period, you should use sanitary towels rather than tampons, as using tampons could increase your risk of infection.
Will I have a follow-up appointment?
You will be asked to attend either a telephone or a face to face follow-up appointment two to three weeks after you have taken the tablets. If appropriate, an ultrasound scan will be arranged as well.
Contact information
Should you need any further advice, or if you have any questions or concerns, please contact one of the following Early Pregnancy Assessment Units.
Queen Elizabeth the Queen Mother (QEQM) Hospital, Margate
Monday to Friday 8am to 3:30pm; Saturday 8am to 2pm
Telephone: 01843 234469William Harvey Hospital (WHH), Ashford
Monday to Friday 8am to 4pm; Sunday 7am to 2pm
Telephone: 01233 616107Out of these hours, please contact:
Birchington Ward, QEQM
Telephone: 01843 234201Women’s Health Suite, WHH
Telephone: 01233 651987