Surgical Management of Miscarriage (SMOM)
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This leaflet is intended to provide some information at this sad time regarding the management of a miscarriage that is not complete.
What is an SMOM?
Surgical Management of Miscarriage is the medical term for surgically removing any parts of your pregnancy that may remain in your womb following a miscarriage. This may include a small fetus, the pregnancy sac, placenta or blood clot or other fetal tissue.
Will I need an SMOM?
An SMOM may be offered to you after an ultrasound scan has confirmed that parts of the pregnancy remain within the womb. Some people choose to wait and see if they pass the contents of the womb naturally, others wish to have a surgical procedure as soon as possible to empty the womb. Whatever decision you make, the doctor and nurse looking after you will ensure appropriate follow up and contact numbers are given.
When will the SMOM happen?
The surgery will be planned for the next available elective list. The nurse/midwife will explain this in detail to you and try to accommodate your specific needs if possible. You planned admission will be to the Day Surgery Unit located within the Treatment Centre.
What will happen to me during an SMOM?
You will be taken to theatre and given a general anaesthetic to ensure you are asleep during the procedure. The neck of the womb may be gently stretched to allow an instrument to be put into the
womb to allow any remaining tissue to be removed. If the pregnancy sac is complete, this is often performed with a suction tube which is more effective at emptying the womb, preventing any
tissue being left behind. The tissue that is removed will be disposed of according to your wishes.
Are there any risks involved?
As with any surgical procedure, there is a very small risk involved. Occasionally the introduction of an instrument into your womb can cause infection or bleeding. Very rarely a perforation of your womb can occur sometimes some tissue can be left behind. Very occasionally a repeat SMOM is required.
What do I need to bring with me?
Overnight bag with toiletries, dressing gown and slippers and something to read. You need to have someone with you to take you home and be with you overnight. You should not travel on public
What will happen following my SMOM?
The short procedure takes place in theatre; you will then wake up in the recovery room. When you return to the ward you will still be feeling sleepy and may experience some abdominal cramping. You will be able to have something to eat and drink and are likely to be discharged home after four hours. If, however, you go to theatre in the evening or at night you may need or wish to remain in hospital overnight.
You may continue to bleed up until your next period, perhaps on and off. The bleeding should not be heavier than a period and it is best to use sanitary towels rather than tampons to avoid infection. You may have abdominal cramps for up to a day after the procedure; this can be relieved with a simple painkiller, such as Paracetamol. You should not drive or operate any machinery until 48 hours after the anaesthetic.
If any of the following occur you should contact your GP:
• Bleeding heavier than a period or pain.
• Offensive vaginal bleeding or discharge and/or increased pain.
• Feel like you have a raised temperature with flu-like symptoms.
There is no set period of time for recovery. Physical recovery is generally a few days but the emotional recovery can be a very slow process. Return to work is very much dependant on you as an individual, your doctor and nurse will advise you more appropriately.
The Next Pregnancy
You can expect your next period any time up to six weeks after your SMOM. It may be heavier and last longer than normal. If you have not had your period by this time, you should seek advice from your GP. You can ovulate (produce an egg) at any time after your SMOM and so you may become pregnant before you have a period. If you have intercourse you may conceive, so it is worth reviewing contraception as soon as possible. It is advisable to wait until you have had at least one period before wishing to conceive naturally again. This allows time for you and your partner to recover emotionally and physically and will also help with accurate dating of the next pregnancy.
Having a miscarriage can be a very distressing experience but it doesn’t have to be a lonely one. There are support groups who can offer you understanding and support or just someone to talk to.
The Miscarriage Association: 01924 200799
Messages can be left at the City Counselling Centre 01908 231131
Early Pregnancy Assessment Unit (EPAU) 01908996434 (Internal Calls Ext: 86434)