Prolonged Bleeding After Miscarriage: Concerns and Solutions

Prolonged bleeding for more than a month after a miscarriage?

I am nearly eight weeks pregnant and have one child already.
I accidentally became pregnant again, and my doctor recommended using medication for a medical abortion (my menstrual cycle has been irregular postpartum, and last year's examination indicated difficulty in conceiving).
On September 23, I took the first dose of the medication for the abortion.
Before taking the second dose, I started passing blood clots.
During a follow-up ultrasound the following week, it was confirmed that the embryo had been expelled.
However, due to continuous bleeding (both blood and clots), I began weekly follow-ups (medications: uterotonics and hemostatics).
During my follow-up on October 10, a urine test revealed a faint positive result.
The doctor prescribed another round of the abortion medication along with hemostatic agents.
During this time, the bleeding remained significant, requiring the use of regular sanitary pads.

On the night of October 14, I began to experience heavy bleeding (requiring the use of extra-long sanitary pads).
It was not an exaggeration to say that the blood was gushing out, accompanied by large blood clots.
During my follow-up on October 24, the doctor prescribed additional hemostatic agents and uterotonics, including Bloodfull S.C.
Since October 14, aside from the ongoing bleeding (with no significant clots), I have been feeling dizzy and uncomfortable while sitting or lying down.
If I get up and move around, the headache becomes very pronounced.

I would like to ask the doctor if there are any methods to stop the bleeding, as I have been feeling very unwell lately, with an increased frequency of headaches and a significant decrease in my immunity.
I am planning for future family planning, and I am concerned whether the damage to my uterus from this incident will make it more difficult to conceive in the future.

Niming, 20~29 year old female. Ask Date: 2016/10/26

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, I’m sorry I cannot diagnose based on the described symptoms.
It is possible that there may be retained products of conception from a miscarriage.
If you continue to experience discomfort, I recommend seeing a gynecologist for a thorough examination.
Wishing you good health.

Reply Date: 2016/10/26

More Info

I'm sorry to hear about your situation. Experiencing prolonged bleeding after a miscarriage can be concerning, and it's important to address both the physical and emotional aspects of this experience.
First, let's discuss the potential causes of prolonged bleeding after a miscarriage. When a miscarriage occurs, the body needs to expel the pregnancy tissue, which can sometimes take longer than expected. If the tissue does not fully pass, it can lead to ongoing bleeding and complications such as infection or retained products of conception. The use of medications like uterotonics (to help the uterus contract) and hemostatic agents (to control bleeding) is common in these situations, but they may not always resolve the issue completely.

Given that you have been experiencing heavy bleeding, especially with the need for extra-long sanitary pads and the presence of blood clots, it's crucial to follow up closely with your healthcare provider. The fact that you are feeling dizzy and experiencing headaches could indicate that you are losing a significant amount of blood, which can lead to anemia. Anemia can cause fatigue, weakness, and dizziness, and it’s essential to address this with your doctor.

Here are some steps you can take to manage your situation:
1. Follow-Up Appointments: Continue to attend all scheduled follow-up appointments with your healthcare provider. They may recommend additional ultrasounds to ensure that all pregnancy tissue has been expelled and to monitor your recovery.

2. Medication Compliance: Make sure to take any prescribed medications as directed. If you are experiencing side effects or if the medications do not seem to be helping, communicate this to your doctor. They may need to adjust your treatment plan.

3. Hydration and Nutrition: Stay well-hydrated and maintain a balanced diet to support your recovery. Foods rich in iron (like leafy greens, red meat, and legumes) can help combat anemia. Your doctor may also recommend iron supplements if your blood tests indicate low iron levels.

4. Rest: Ensure you are getting enough rest. Your body is going through a significant recovery process, and adequate sleep can help support your immune system and overall health.

5. Monitor Symptoms: Keep track of your symptoms, including the amount of bleeding, any pain, and how you feel overall. If you notice any worsening symptoms, such as increased bleeding, severe pain, or signs of infection (like fever or foul-smelling discharge), seek medical attention immediately.

6. Emotional Support: Miscarriage can be an emotionally challenging experience. Consider seeking support from friends, family, or a mental health professional who can help you process your feelings and provide emotional support.

Regarding your concern about future pregnancies, while a miscarriage can be physically and emotionally taxing, many women go on to have successful pregnancies afterward. However, if there are concerns about uterine health or any complications from this miscarriage, your healthcare provider may recommend further evaluation or monitoring before you try to conceive again.

In summary, it’s vital to maintain open communication with your healthcare provider, adhere to treatment plans, and take care of your physical and emotional health during this challenging time. Your body needs time to heal, and with appropriate care, you can work towards recovery and future family planning.

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