Abnormal Bleeding After Miscarriage: When to Seek Medical Attention?

Q: Abnormal Bleeding After Miscarriage: When to Seek Medical Attention?

Hello： After a miscarriage, the first consideration for bleeding is the possibility of retained fetal tissue or membranes that have not been completely expelled. <br>Secondly, abnormal ovulation following the miscarriage can lead to abnormal uterine bleeding. <br>The most severe

Abnormal bleeding after a miscarriage?

I had a natural miscarriage at the beginning of last month.
I saw a doctor who performed an internal examination and confirmed that everything was cleared out.
The doctor prescribed hemostatic medication and menstrual regulation medication, stating that I should take the hemostatic medication only if I was bleeding.
After taking it, the bleeding stopped for a few days, but it resumed.
After my follow-up appointment, I received a hemostatic injection and took medication, but again, after a few days of taking the hemostatic medication, I experienced heavy bleeding.
Should I go for another follow-up appointment?

Xuan, 10~19 year old female. Ask Date: 2016/08/14

Dr. Yang Wangjun reply Obstetrics and Gynecology

Hello: After a miscarriage, the first consideration for bleeding is the possibility of retained fetal tissue or membranes that have not been completely expelled.
Secondly, abnormal ovulation following the miscarriage can lead to abnormal uterine bleeding.
The most severe condition is invasive placenta (chorionic tissue), where chorionic cells invade the myometrium, resulting in significant bleeding.
Regardless of the cause, since there is frequent and heavy bleeding, I recommend performing a complete dilation and curettage (D&C) procedure first, followed by hormonal therapy to regulate the menstrual cycle.
Thank you for your message!

Reply Date: 2016/08/14

More Info

After experiencing a miscarriage, it is not uncommon for women to have some bleeding as the body adjusts and heals. However, abnormal or excessive bleeding can be a cause for concern and may require further medical evaluation. Given your situation, where you have already seen a doctor and have been prescribed medications to manage the bleeding, it is important to monitor your symptoms closely.

In general, you should seek medical attention if you experience any of the following:
1. Heavy Bleeding: If you are soaking through one or more pads an hour for two consecutive hours, this is considered heavy bleeding and warrants immediate medical attention.

2. Severe Pain: While some cramping can be expected after a miscarriage, severe or worsening pain that is not relieved by over-the-counter pain medications should be evaluated by a healthcare professional.

3. Foul Smell: If you notice a foul odor coming from the vaginal area, it could indicate an infection, which requires prompt treatment.

4. Fever: A fever over 100.4°F (38°C) can be a sign of infection and should be addressed immediately.

5. Persistent Symptoms: If you continue to experience abnormal bleeding despite taking prescribed medications, it is crucial to follow up with your healthcare provider. This could indicate that there are retained products of conception or other complications that need to be addressed.

6. Emotional Distress: Miscarriage can be an emotionally taxing experience. If you are feeling overwhelmed, anxious, or depressed, it is important to reach out for support, whether from a healthcare provider or a mental health professional.

In your case, since you have already experienced ongoing bleeding despite treatment, it would be advisable to return to your doctor for further evaluation. They may perform an ultrasound to check for any retained tissue or other complications that could be contributing to the bleeding. Additionally, they might consider adjusting your medication or exploring other treatment options.

It is also important to keep in mind that every woman's body responds differently after a miscarriage, and healing can take time. While some women may return to their normal menstrual cycle relatively quickly, others may experience irregularities for a few months.
In summary, if you are experiencing abnormal bleeding after a miscarriage, especially if it is heavy or persistent, it is essential to seek medical attention. Your health and well-being are paramount, and your healthcare provider can help ensure that you receive the appropriate care and support during this time.

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