Understanding Post-Miscarriage Bleeding and Clots

Question
I had a natural miscarriage that was incomplete on 12/5/08 and passed large clots and bled heavily for a few hours.  Had a pelvic exam and my cervix was open and had an ultrasound the next day confirming my miscarriage.  Was told to follow up with my Dr the next week for blood.  On 12/9/08 in the morning i started cramping again and passed another large clot and a few smaller ones (bleeding and clotting only lasted about an hour or so) and went to the Dr and he said that everything was fine and to have my blood tested in about a week.  My main question is is it normal to pass more clots when i miscarried on the 5th and it is now the 9th? I know that the ultrasound showed that there was still something left. I expect that i will bleed for some time after when should i be concerned if i am still cramping and clotting?


Answer
Hi Sara
       I''m sorry to hear of your loss, I hope you feel better very soon.
If an ultrasound confirmed some remaining tissue then you are usually offered a D&C. This is a small surgical procedure which involves removing the tissue with gentle suction under a general anaesthetic. It will require you to stay in hospital for a day, but you can usually go home the same day unless otherwise required to.

If you weren't offered this then it may be worth enquiring into it. Remaining tissue can cause heavy & prolongued bleeding, it can also become infected so as a general rule they normally at least offer a D&C rather than leaving it.
On the other hand the doctor may have decided that there was only a minimal amount of tissue left and felt it wasn't necessary to carry out a D&C.

Considering your miscarriage was incomplete then the clots and bleeding are perfectly normal. It's simply the remaining tissue being passed. It should setrtle in the next week.
In the meantime be sure to wear sanitary pads instead of tampons. See your doctor straight away if you experience any of the following symptoms:
Foul smelling/unusual coloured discharge
A high temperature
Cramping which has got worse
Bleeding which has become heavier
General feeling of being unwell

I would say if you're still bleeding heavily & passing clots by next week then you need to go back to your doctor. Keep up your fluids & be sure to get plenty of iron, as blood loss can lead to anaemia.
Follow your instincts - if you feel something isn't right then act upon it.

I hope this has helped you. Please do come back if you have any other queries.

Kindest Regards
Sarah