Should we be concerned that misoprostol ended miscarriage symptoms?
January 18, 2014 12:59 AM   Subscribe

My wife was having a miscarriage and was given misoprostol to accelerate the process. She took 4 tablets of 200mg misoprostol under the tongue and 800mg ibuprofen right after that. The signs of miscarriage (considerable pain and bleeding) went away completely after she took the medication. Is this normal?

My wife is in the late 11th week of her pregnancy. She had bleeding/spotting on Thursday, we called her doctor's office, and were told to go to the emergency, where they said there was no heartbeat from the fetus, the fetus size was consistent with 10 weeks of pregnancy, and she was most likely having a miscarriage. They told us to call the ob-gyn first thing in the morning and let us go home.

When we went to the ob-gyn on Friday, my wife was in considerable pain (when asked by the nurse, she rated it 8/10) and the bleeding had increased considerably. The doctor said she was indeed having a miscarriage, and prescribed misoprostol to quicken the process. We came home, she took the misoprostol (4 tablets of 200mg, under the tongue), and 800mg of ibuprofen right after it.

She shivered for a while after that, and then, nothing. The bleeding almost stopped, and the pain went away almost completely. We first thought that was temporary and due to the ibuprofen, but it has been 14 hours since she took the pills, and still, nothing.

I understand misprostol is not always effective in accelerating (or inducing) miscarriages, and some websites mention repeating the 800mg dose three times (and apparently misoprostol is more effective when taken together with other medicine like methotrexate or mifepristone). But I'm puzzled that her miscarriage symptoms went away completely.

Do you think this response is normal?

I know this is not a medical forum, but my wife is sleeping now and I'm trying to learn as much as I can while trying to watch her. When we called the on-call doctor earlier this evening and asked what we should do if nothing happens, we were told to see the doctor on Sunday morning if she does not have a miscarriage until then.
posted by palet to Health & Fitness (14 answers total)
I don't have any experience of misoprostol, but the pain/bleeding of miscarriage can indeed stop and start like this, so that part doesn't necessarily have anything to do with the drug.

Definitely give the on-call doctor another ring if you're still concerned and nothing's happening, though.
posted by Catseye at 1:38 AM on January 18, 2014 [1 favorite]

Thanks Catseye.
posted by palet at 1:45 AM on January 18, 2014

I'm sorry to hear what you are going through; It sounds like you are in good hands medically. Is it possible she has already passed the fetus and didn't notice in her considerable pain? I seem to remember the pain and blood eased off almost completely once the miscarriage was complete. Keep an eye on your wife, especially for fever, and keep her medical team in the loop. My thoughts are with you.
posted by saucysault at 4:35 AM on January 18, 2014 [2 favorites]

I can't answer your question about the misoprotol directly but I can echo what saucysalut mentioned above. As soon as I passed the fetus during my miscarriage the pain was essentially gone. If she was already bleeding could this have happened? It's pretty dramatic so it's hard to miss. Also, FWIW, I did not have a violently painful reaction to misoprotol like many people do so there is that too.

Hugs. This is terrible. I'm sorry.
posted by teamnap at 5:45 AM on January 18, 2014

saucysault and teamnap, thanks for your thoughts and for sharing your experiences. I do not think she has already passed the fetus. Still nothing this morning, I guess we'll talk with the doctor tomorrow if nothing happens until then.
posted by palet at 7:32 AM on January 18, 2014

My miscarriage was at 12 weeks but the fetus died somewhere around 8 weeks. Given the size I was given the choice to miscarry at home or get a D and C. My doctor was on the fence because she felt like 8 week old fetus was pushing the boundaries of what she felt comfortable using misoprostol. She mentioned that sometimes it didn't work and a D and C was required anyway. Maybe that's what is going on with your wife. I just remembered that part now that the fog of the morning has cleared my mind.
posted by teamnap at 8:22 AM on January 18, 2014

Thank you for the update, the doctor had given us the choice, too, and it had seemed like he was in favor of misoprostol. After some discussion, my wife decided to go with misoprostol, but we may end up with the D and C, too.
posted by palet at 8:31 AM on January 18, 2014

I can't speak to misprostol, but I had a miscarriage at 13 weeks. Noticed spotting, went to the OB, they said no heartbeat, scheduled me for a D&C next day. That morning I spent a lot of time bleeding. When I went for the D&C there was no fetus. So it must have passed, but I didn't notice.

So sorry about this.

For what it's worth, that was my first pregnancy, and I was able to get pregnant again fairly quickly and neither of the next two pregnancies had any issues.
posted by leahwrenn at 8:32 AM on January 18, 2014 [1 favorite]

Thank you leahwrenn.
posted by palet at 8:55 AM on January 18, 2014

Did they give her another round of pills? That's what my doc did...with instructions to repeat the dosage if the first round didn't get things started within 12 hours or so. I miscarried at 8 heartbeat at first appointment, rechecked after a week and still not there, and I chose misoprostol instead of a D&C. I inserted two tabs close to my cervix and took two by mouth and things started up for me about 6 hours later. It also took me about two days of moderate bleeding and cramps to pass the fetus.

I'm so sorry for y'all.
posted by Mimzy at 10:16 AM on January 18, 2014

Is it possible she passed the fetus during a bowel movement? Sad to say, that's how my (natural) miscarriage at 12 weeks ended. Baby came out with the urge to bear down.

Simply follow the instructions of the doctor and ensure your wife has enough fluids, food, and rest. Waiting is the hardest part of any medical procedure. So sorry.
posted by crazycanuck at 4:47 PM on January 18, 2014

Thanks guys. I do not think she has passed the fetus but we'll see (or at least talk with) the doctor tomorrow morning if nothing happens until then. She still has very little bleeding and no pain/cramps.
posted by palet at 4:56 PM on January 18, 2014

FYI, the fetus when I had my miscarriage at about ten weeks was almost completely overlooked by me because it was so small. It just looked like a blood clot. I hope you get closure soon.
posted by saucysault at 8:27 PM on January 18, 2014

We talked with the doctor and he, too, told us that his best guess was my wife did not notice passing the fetus. She doesn't think that was the case (she had one early miscarriage before and says it was impossible not to notice what happened then, but maybe things vary from case to case). Hopefully we'll learn tomorrow at the ultrasound. Thanks for all the support guys.
posted by palet at 4:01 PM on January 19, 2014

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