Bleeding After Taking RU486: What to Expect - Obstetrics and Gynecology

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When considering the use of RU486 (mifepristone) for medical abortion, it is essential to understand the expected physiological responses and the timeline of events that typically follow its administration. RU486 is commonly used in combination with another medication called misoprostol to terminate an early pregnancy, usually within the first ten weeks.
In your case, having taken the first dose of RU486 on September 20 and the second dose on September 22, the bleeding and passage of tissue you experienced are generally expected outcomes. After taking RU486, many individuals report experiencing some bleeding, which can vary in intensity and duration. This bleeding is often similar to a heavy menstrual period and may include the passage of blood clots and other tissue, which can be a sign that the pregnancy is being expelled from the uterus.

The presence of blood clots and the "white soft tissue" you mentioned could be part of the normal process of expelling the contents of the uterus. The "soft white tissue" could be the gestational sac or other pregnancy-related tissue. It is important to note that while some bleeding is normal, the amount and duration can vary significantly from person to person.

Typically, after taking RU486, you might expect the following:
1. Bleeding: Light to moderate bleeding usually begins within a few days after taking the first dose. This bleeding can last for several days to a couple of weeks. It may start as spotting and progress to heavier bleeding, similar to a menstrual period.

2. Cramping: Along with bleeding, cramping is common as the uterus contracts to expel its contents. The intensity of cramps can vary, and over-the-counter pain relief can be used to manage discomfort.

3. Follow-Up: It is crucial to have a follow-up appointment with your healthcare provider within a week or two after taking the medication to ensure that the abortion is complete. This may involve an ultrasound or a physical examination to confirm that there are no remaining products of conception in the uterus.

4. Signs of Complications: While most individuals experience a normal process, it is essential to be aware of signs that may indicate complications. These include:
- Heavy bleeding (soaking through two or more pads in an hour for two consecutive hours)
- Severe abdominal pain that is not relieved by over-the-counter medications
- Fever or chills
- Foul-smelling discharge
If you experience any of these symptoms, it is crucial to seek medical attention promptly.

In summary, the bleeding and tissue passage you experienced after taking RU486 are generally normal and expected. However, it is essential to monitor your symptoms and follow up with your healthcare provider to ensure that the process is proceeding as it should. If you have any concerns or if your symptoms change, do not hesitate to reach out to your healthcare provider for guidance and support.