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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]I'm so sorry for your loss, OP.  I had a missed miscarriage where the baby had stopped growing 4 weeks before.  I opted for the Cytotec and it wasn't as bad for me as some of these other posters.  The cramping was painful, but definitely not unbearable.  I think I just took ibuprofen.  I didn't have any vomiting or diarrhea.  The Cytotec didn't work for me after about 36 hours, so I got a D&C instead.  The D&C ended up being a really positive experience for me.  I got pregnant again 6 months later and just had a baby.

Based on my experience, I would take the Cytotec over doing nothing but call your doctor for more explicit instructions and to ask about pain management.  I personally preferred to get the physical part over with so I could start healing emotionally.  Good luck to you.  I'm so sorry you're going through this.[/quote]

FYI, the WHO recommends that the effectiveness of Cytotec be judged after ONE WEEK, not 36 hours. Shady Grove allowed 3 days, which I thought was bullshit. It's over 90% effective if you give it the full week. Look up the WHO info on misoprostol. It is used safely all over the world. If I were a cynic I'd say that it's not used in America very much because it's such a cheap and non-interventionist option. And doctors who do use it don't use it properly and then claim it doesn't work. SG told me it was only 60% effective. If it's  60% effective for them, they are using it wrong. Luckily I did my own research. [/quote]

I'm one of the PPs who thinks cytotec is a better first-line option.  I just used it last weekend, and I'm not sure everything has passed, so I'm not sure if I'll need the D&C anyhow.

But here's my question, what is the effective way to use it?  I've read most doctors give two doses.  Mine only did one, and he's definitely pushing the D&C.  I have a slight worry that maybe I should have gotten two doses.

But I agree, it is much less invasive than the D&C.  And I don't think people realize the risks with the D&C.  It's possible as well that they don't get everything out with a D&C.  After all, it's not like they have great visibility where they are scraping.  And that's what scares me the most.

I have also read in some places that it actually isn't a big deal if not everything comes out right away.   I don't know if this is true, but I read somewhere that usually, it will all come out in your next period.

I have strong reservations about the D&C.  I felt like I was pushed into one on my last miscarriage and it reduced my lining too much and possibly caused damage that led to the current miscarriage.  It seems to me a relatively recent thing that D&Cs are standard after first trimester miscarriages.  So many older women who have had early (first trimester) miscarriages just say they passed everything naturally.  They didn't even have the option of the cytotec.  Sure, it was drawn out and miserable, but it doesn't sound like they all got infections.  It seems to me that the D&C (where they force open your cervix and use tools to scrape out your uterus) has a greater infection risk than a natural miscarriage or one that is *sped up* with cytotec.  Perhaps there aren't more infections with D&Cs because they give you doxy (antibiotic) during the procedure and after.  It isn't necessarily that they get everything out.

[b]But again, I'm curious to hear what you think is the correct way to use the cytotec.  [/[/b]quote]

http://www.misoprostol.org/File/guidelines.php

For missed miscarriage, the guidelines supported by clinical studies are:
   -   800mcg vaginally 3-hrly (max x2) or sublingual 600mcg 3-hourly (max x2)
   -   Give 2 doses and leave to work for 1-2 weeks (unless heavy bleeding or infection)

I often hear of dosages that are two low, or are not repeated, or (most common) not given enough time to work.

I am not asking anyone to trust a stranger on the internet rather than their own doctor. I am urging women to do their own research, to learn about global standards and the long history of the safe use of misoprostol, and not to assume that every reproductive endocrinologist/gynecologist/obgyn is up to date on the research about the prevalence of Asherman's and the safe use of misoprostol/cytotec. Because I can assure you: they are not.

70% or so of women will sail through a D&C with absolutely no problems. But that's cold comfort if you're part of the 30%.

Please, please educate yourself. I didn't and I lost the ability to have another child. Educate yourself and make sure that you are comfortable with the relative risks and benefits of D&C vs. misoprostol. [/quote]

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