Post-Abortion Concerns: Risks and Follow-Up Care

Post-abortion issues!

Hello, I would like to ask some professional questions.
My wife underwent a suction abortion on December 5th.
At the time of the abortion, she was approximately 7 weeks and 5 days pregnant.
However, after the procedure, the doctor informed us that her uterus was somewhat unique, with a more severe anteverted cervix that was smaller, making it difficult for the medical instruments to completely remove the embryonic tissue from the top of the uterus.
The doctor expressed concerns about the risk of damaging the internal uterine lining and mentioned that there is still a risk of incomplete evacuation with RU486.
Nevertheless, on the day of the procedure, after the doctor's recommendation, she took RU486 orally to help expel the remaining tissue.
I would like to ask if this management approach is ideal.
Can we confirm through ultrasound later that all residual tissue has been completely expelled? If there is indeed a situation of incomplete evacuation in the future, what would be the subsequent management options? Thank you for your assistance!

bgpower753, 20~29 year old female. Ask Date: 2016/12/08

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, please follow the obstetrician's instructions for further observation.
Wishing you good health.

Reply Date: 2016/12/08

More Info

Post-abortion care is crucial for ensuring the health and well-being of individuals who have undergone the procedure. In your case, your wife had a suction abortion at approximately 7 weeks and 5 days gestation, and there are specific considerations to keep in mind regarding her recovery and follow-up care.

Firstly, the fact that the doctor noted a "special" condition of the uterus, including a more severe anterior cervical condition and a smaller cervix, is significant. These anatomical variations can complicate the abortion procedure and may increase the risk of incomplete abortion, which occurs when some of the pregnancy tissue remains in the uterus after the procedure. The use of RU486 (mifepristone) post-procedure is a common approach to help expel any remaining tissue, but it is essential to monitor its effectiveness.

Regarding the handling of your wife's situation, the decision to use RU486 after the suction abortion was likely made to minimize the risk of retained products of conception (RPOC). This approach can be beneficial, but it is crucial to follow up with appropriate medical care. The use of ultrasound is an effective method to confirm whether the uterus is clear of any remaining tissue. Typically, a follow-up ultrasound is recommended within one to two weeks after the procedure to ensure that the uterus is empty.

If the ultrasound indicates that there is still retained tissue, the treatment options may include:
1. Medication: Additional doses of mifepristone or misoprostol may be prescribed to help expel the remaining tissue.

2. Surgical Intervention: If medication is not effective or if there are significant complications, a repeat suction curettage may be necessary to remove any retained products.

3. Monitoring: In some cases, if the retained tissue is minimal and not causing any symptoms, the doctor may recommend a watchful waiting approach, with close monitoring of symptoms and follow-up appointments.

In terms of future pregnancies, it is essential to discuss with your healthcare provider any potential risks associated with the previous abortion, especially considering the unique anatomical features of your wife's uterus. While many individuals can conceive and carry a pregnancy to term after an abortion, any complications or concerns should be addressed with a specialist in obstetrics and gynecology.

Post-abortion care also includes monitoring for any signs of complications, such as heavy bleeding, severe pain, fever, or foul-smelling discharge. If any of these symptoms occur, it is crucial to seek medical attention promptly.

In summary, the approach taken with your wife seems reasonable given the circumstances, but close follow-up care is essential. Regular check-ups, including ultrasounds, will help ensure that her recovery is progressing well and that any potential complications are addressed promptly. Always feel free to reach out to your healthcare provider with any questions or concerns during this recovery period.

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