Continuous Bleeding After Abortion: Causes and What to Expect

Q: Continuous Bleeding After Abortion: Causes and What to Expect

Hello： (1) Continuous bleeding after taking abortion medication primarily leads to anemia. <br>Typically, this situation can be managed in an outpatient setting through dilation and curettage (D&C) to remove any retained decidual tissue, which can help stop the bleeding. <br>Addi

Continuous bleeding after abortion?

Hello Doctor: I took RU486 on May 24th and started taking contraction medications on May 26th.
At that time, I discovered that I was two weeks pregnant.
On the day I took the contraction medication, I experienced increased bleeding, and I also took herbal medicine.
After May 26th, I had follow-up appointments every three days and continued with supportive care.
During my follow-up on June 4th, the doctor said that there was nothing visible on the ultrasound and that everything appeared clean.
However, as of June 23rd, I am still experiencing continuous but light bleeding, which is a deep brown color.
On June 18th, I had another follow-up appointment, and the doctor mentioned that it might be an issue with retained tissue and prescribed contraction medication again.
I would like to ask the doctor what the implications of this ongoing bleeding are.
Is it due to retained tissue? How much longer might this bleeding last? And how should I calculate my future menstrual cycles?

hua, 20~29 year old female. Ask Date: 2016/06/23

Dr. Yang Wangjun reply Obstetrics and Gynecology

Hello: (1) Continuous bleeding after taking abortion medication primarily leads to anemia.
Typically, this situation can be managed in an outpatient setting through dilation and curettage (D&C) to remove any retained decidual tissue, which can help stop the bleeding.
Additionally, estrogen and progesterone can be used to regulate the menstrual cycle and stabilize the endometrium, which should also help stop the bleeding.
(2) The timing of the next menstrual period after a miscarriage usually varies depending on the gestational age of the fetus, with an average onset around 42 days post-miscarriage.
However, if bleeding persists, it may delay follicular growth in the next cycle, making the timing of the next menstrual period unpredictable.
Thank you for your message!

Reply Date: 2016/06/23

More Info

Continuous bleeding after an abortion can be a concerning experience for many individuals. It is essential to understand the potential causes, implications, and what to expect moving forward. Based on your situation, you have been experiencing prolonged bleeding since your medical abortion on May 24, which has persisted until June 23, with the blood being dark brown in color. This scenario raises several questions regarding the underlying reasons for the bleeding, its duration, and its potential impact on future pregnancies.

Causes of Continuous Bleeding After Abortion
1. Incomplete Abortion: One of the most common reasons for ongoing bleeding after a medical abortion is the retention of placental or fetal tissue within the uterus. If the body does not expel all the tissue, it can lead to continued bleeding. This is often accompanied by cramping and may require further medical intervention, such as a follow-up procedure to clear the uterus.

2. Hormonal Changes: After an abortion, the body undergoes significant hormonal shifts as it returns to its pre-pregnancy state. These hormonal fluctuations can lead to irregular bleeding patterns, including spotting or prolonged bleeding.

3. Infection: Although less common, an infection in the uterus can cause abnormal bleeding. Signs of infection may include fever, foul-smelling discharge, or severe abdominal pain. If you experience these symptoms, it is crucial to seek medical attention promptly.

4. Uterine Contractions: The medications used during a medical abortion, such as mifepristone and misoprostol, are designed to induce uterine contractions to help expel the pregnancy. Sometimes, these contractions can lead to intermittent bleeding as the uterus continues to contract and expel any remaining tissue.

Duration of Bleeding
The duration of bleeding after an abortion can vary significantly among individuals. Generally, light bleeding or spotting can last for a few days to several weeks. If you are experiencing dark brown blood, it may indicate older blood that is taking longer to exit the body. However, if the bleeding persists beyond a few weeks or becomes heavier, it is essential to follow up with your healthcare provider. They may recommend an ultrasound to check for any retained tissue or other complications.

Impact on Future Pregnancies
In most cases, if the bleeding is due to incomplete abortion and is addressed appropriately, it should not have a long-term impact on your fertility or future pregnancies. However, if there are complications such as infection or significant retained tissue, these could potentially affect future reproductive health. It is vital to communicate openly with your healthcare provider about your concerns and any symptoms you experience.

What to Expect Moving Forward
1. Follow-Up Care: It is crucial to attend all follow-up appointments with your healthcare provider. They may perform an ultrasound to ensure that your uterus is clear of any remaining tissue and assess your overall recovery.

2. Monitoring Symptoms: Keep track of your bleeding patterns, including the color, amount, and any associated symptoms such as pain or fever. This information will be helpful for your healthcare provider in assessing your condition.

3. Menstrual Cycle Resumption: After an abortion, it may take some time for your menstrual cycle to return to its regular pattern. Typically, ovulation can occur as soon as two weeks after the procedure, and your first period may return within four to six weeks. However, this can vary based on individual hormonal levels and overall health.

4. Emotional Support: Experiencing an abortion can be emotionally challenging. It is essential to seek support from friends, family, or professional counselors if you are struggling with your feelings during this time.

In conclusion, while continuous bleeding after an abortion can be concerning, understanding the potential causes and implications can help you navigate this experience. Regular follow-up with your healthcare provider is essential to ensure your recovery and address any complications that may arise. If you have further questions or concerns, do not hesitate to reach out to your healthcare provider for personalized guidance and support.

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