Being pregnant can be a joyous
and
exciting time in a woman's life.
Hearing
your baby's heartbeat for the
first time,
picking out their name,
designing the
nursery, and even planning their
future.
It can also be very
nerve-wracking you
want nothing more than to
protect this
new life you are creating.
I'm a
mother
to two girls-- Arianna is 11
years old and
Victoria is 10 years old-- over
the past
couple years I've been kind of
yearning
to try again for possibly a
little boy.
When I found out I was pregnant
I was a
little nervous because I'm a
little bit
older-- cuz I'm over 35-- but I
felt really
positive about this pregnancy.
At the
nine-week appointment Dr. Cohen
showed
me the baby's heartbeat, so I
was really
excited about that.
The same
week I began
spotting-- The spotting started
for about
a day, it started to increase in
intensity.
I called Dr. Cohen's
office
and they told me to come in and
they'll
do an ultrasound
courtesy to make sure that
everything
was okay.
The ultrasound
technician, I was
asking her questions and she
didn't want
to answer any of the questions,
she was
telling me that I need to talk
to the
doctor.
So they put me in the
waiting
room and I waited, and I started
really
getting nervous about everything
and on
my way back into the room I saw
my chart
on the door and there was a
little
sticky note on it and the sticky
note
said, she doesn't know yet.
I
immediately
kind of already knew what was
gonna
happen and that they were gonna
tell me
that I miscarried.
And at that
point I
had a lot of emotions, I didn't
know what
to think but I knew whatever it
was the
doctor was gonna tell me it
couldn't
have been good.
Early pregnancy loss, or EPL,
can be
heartbreaking and can affect a
woman not
only emotionally but physically
as well.
After finding out that she had
miscarried, Carlin was given
three
options; watch and wait, which
allows the
miscarriage to happen on its
own; take
medication, which allows the
miscarriage
to happen sooner; or have a D&C
performed,
which allows the doctor to
remove the
pregnancy.
After being given the
three
choices I wasn't sure what I
wanted to
do, so I told the doctor that I
was gonna
go home and do some research to
figure
out which option would work best
for me.
I didn't understand why this
happened or
how something like this could
happen, I
asked the doctor and the doctor
informed
me that these things can happen
and that
miscarriage, especially in the
first
trimester is common.
Pregnancy
loss is
defined as loss during the first
13
weeks of pregnancy.It can be
either,
intentional or unintentional--
there are
many causes of unintentional
early
pregnancy loss, around 50% of
the time
it's due to chromosomal, whether
it be
micro deletions, deletions, or
an
unexplained chromosomal anomaly
that may
occur.
There's maternal indications
whether
there is hormonal infection or
there's
an underlining autoimmune
disorder
within the patient, and also we
have our
alcohol abuse, drug abuse,
excessive
caffeine intake, smoking,
malnutrition,
improper or abnormal
implantation of the
fetus, and also advanced
maternal age.
Before I could make a decision
my body
kind of made that decision of
for me;
After a few days I started to
bleed very
heavily and I was passing clots,
and I
was in a lot of pain.
The
cramping and the
bleeding was so severe in the
middle of
the night I felt a very full
feeling,
like a lot of pressure, and I
ran to the
bathroom, stepped inside of the
bathtub,
and all of the blood just
started coming
out.
Some of the physical
effects that
are associated with early
pregnancy loss
include; moderate to severe
cramping,
bleeding, rarely fever, a
patient may
continue to bleed within 48
hours, or 72
hours after a loss-- If a
patient
continues to bleed where she's
going
through as I tell them, a pad an
hour,
it is important that they seek
care
either by their healthcare
professional
or to an emergency room.
It's
important
to educate your patients and to
let them
know if the bleeding persists
and it's
hard for them to even get up and
walk to
the bathroom because of
dizziness, or
they feel like they're gonna
faint, these
are signs and symptoms that the
patient's may be having an
increased
amount of blood loss and they
need care
immediately.
In our office all
our
patients when they come in with
suspected or with early
pregnancy loss, a
hemoglobin is checked in our
office,
that tells us pretty much how
much the
patient has been bleeding or how
much
blood they've lost during this
type of
miscarriage.
Now why is that so
important?
Because we really don't want to
send a
patient home if her hemoglobin
is low
with the risk of possibly
needing a
blood transfusion or passing out
while
they're driving home, or having
an
accident at home.
It will also
dictate
our management at that time
whether we
need to do something
immediately, whether
it be in the office or in the
hospital--
such as a DNC-- or if the
patient's blood
volume is stable, we could send
them home
with medication.
Dr. Cohen then
asked me
to come in for ultrasound.
I was
informed
that I still had some tissue
remaining,
so then I was again given the
same
choice as to whether or not I
wanted to
take medication to help
with passing the tissue or if I
wanted
to have a DNC procedure
completed to
have the tissue removed.
I
decided to go
with the medication, he
prescribed me a
tablet called Methergine.
The
Methergine
tablet helped to slow down the
bleeding
and it also helped me to expel
some of
the tissue that I still had left
inside
of me but in the end I still
ended up
having to get a DNC procedure.
Bleeding
due to early pregnancy loss, or
EPL,
warrants expectant management to
avoid
complications.
Methergine, a
uterotonic,
along with another medication,
Misoprostol, is commonly used
for early
pregnancy lost hemorrhage.
Methods and
tablets have a rapid onset of 5
to 10
minutes is in an appropriate
first-line
agent to manage early pregnancy
lost
hemorrhage.
I was really excited
about being
a mom again, my girls wanted
another
little sister but I really,
really wanted
a little boy of my own.
But I
will never
know whether I was having a boy
or a
girl-- One of the toughest
things our
patients will deal with is early
pregnancy loss, whether it be in
the
first trimester or the last
trimester, a
loss is a loss and it's to be
dealt with
that on an emotional level.
It
is up to
us to help our patients get
through
these tough times not only
physically
but also mentally.
And even if
you do go
through something as terrible as
a
miscarriages, what I went
through, if you
want a baby
definitely go after your dream,
go after
what you want because in the end
what
you will gain is, is far more
than what
you lost.
For more information
on EPL you
can visit Methergine dot com or
just log on
to access health dot TV.
What
is Methergine
used for?
Methergine is used
just after a
baby is born to help deliver the
placenta, also called the
afterbirth, it
is also used to help control
bleeding
and to improve muscle tone in
the uterus
after childbirth.
Who should not
take
Methergine?
If you suffer from
hypertension, high blood
pressure, if you
experienced one of the common
complications of pregnancy,
called
toxemia, sharp rise in blood
pressure,
leakage of large amounts of the
protein
albumin into the urine, and
swelling of
the hands, feet, and face, if
you are
pregnant,
if you are allergic to
Methergine.
How
should I take Methergine?
One
tablet
three or four times daily, for a
maximum
of one week.
What should I avoid
while
taking Methergine?
Grapefruit
and
grapefruit juice may interact
with
Methergine and lead to unwanted
side-effects.
Discuss the use of
grapefruit products with your
health
care provider.
What warning should I know about
Methergine?
Do not breastfeed
within 12
hours after taking Methergine.
Methergine
may pass into breast milk in
small
amounts and could affect a
nursing baby.
In some cases you will need to
use this
medication for up to one week
after your
baby is born.
You may need to
use a
breast pump to establish and
maintain
your milk flow until your
treatment is
finished.
If you use a breast
pump during
this time, throw out any milk
you collect.
Inform your doctor if you have
kidney or
liver problems, since these
conditions
can adversely affect Methergine
activity.
If you have a heart disease,
coronary
artery disease, smoke, or are
obese, have
diabetes, or high cholesterol
you may be
at a higher risk for Methergine
to cause
narrowing of the arteries, which
may lead
to a heart attack.
What other
medications
might interact with Methergine?
There are
a number of drugs affected by,
or will
affect the way Methergine works.
Tell
your doctor about all medicines
you use
including prescription,
over-the-counter,
vitamins, and herbal products.
What are
the possible side effects of
Methergine?
The most common side effect is
high
blood pressure, associated with
seizure
and/or headache.
Other possible
side
effects include low blood
pressure,
stomach pain caused by uterine
cramps,
nausea, and vomiting.
Tell your
doctor if
any of these symptoms are severe
or do
not go away.
Call your doctor
immediately
if you experience seizures,
chest pain or
discomfort, slow or fast
heartbeat,
difficulty breathing,
dizziness, swelling of the foot
or leg,
skin rash, swelling of the
eyelids or
around the eyes, face, lips, or
tongue--
These are not all possible side
effects
of Methergine and others may
occur, if you
notice other effects not listed
above
contact your doctor or
pharmacist.
You
may report side effects to the
FDA at www dot
FDA dot gov forward-slash
MedWatch or call
1-800-FDA-1088 or contact
Lupin Pharmaceuticals, Inc. at
1-800-399-2561
for more complete information
about
Methergine and your specific
health
needs, talk with your doctor
pharmacist.
FDA-approved
labeling can be
found at www.
Methergine.com
