The management of the pregnant client who has experienced a pregnancy loss depends on the type of miscarriage and her signs and symptoms.While planning care for a client who desires outpatient management after a first-trimester loss,the nurse expects the plan of care to include:

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Outpatient management of a first-trimester loss is safely accomplished by the use of misoprostol intravaginally for up to 2 days.If there is uncontrollable bleeding,unstable vital signs,or signs of infection a surgical evacuation should be performed.D&C is a surgical procedure that requires dilation of the cervix and scraping of the uterine walls to remove the contents of pregnancy.This procedure is commonly performed to treat inevitable or incomplete abortion and should be done in the hospital.D&E is usually performed after 16 weeks of pregnancy.The cervix is widely dilated followed by removal of the contents of the uterus.Ergot products such as Methergine or Hemabate may be given for excessive bleeding after miscarriage.

The Management of the Pregnant Client Who Has Experienced a Pregnancy