Embryonic Sac Atrophy and Medication Guidance

Embryonic sac atrophy, taking Hiccup?

On March 19, I should have been 7-9 weeks pregnant, and there should have been signs of embryonic heartbeat, etc.
However, during the follow-up visit, the doctor said that my gestational sac was atrophied, and no signs of embryo or heartbeat were observed.
After the follow-up on March 25, the doctor prescribed Hiccup Quenching and painkillers.
I would like to ask if I need to take four tablets of Hiccup Quenching at once (it says to take four tablets immediately)? Do I need to fast before taking it? Is it necessary to wait six hours after taking the painkillers before I can take them? If I am in significant pain, can I take them earlier?

Weiwei, 20~29 year old female. Ask Date: 2017/03/26

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Medical abortion generally requires the use of two types of medications.
First, a drug that inhibits embryo development is taken, followed by a second medication that induces uterine contractions to expel the embryo 2-3 days later.
Most individuals experience abdominal pain due to uterine contractions about two hours after taking the second medication.
Typically, after taking the medication, patients can be observed in the hospital for six hours before being discharged, with continued bleeding for 1-2 weeks.
A follow-up ultrasound can be performed at the hospital to check if the uterus is clear.
The medical abortion process primarily targets early pregnancies less than 45 days.

How is a medical abortion performed? The process includes:
1.
Strict screening before medication use, which involves taking a medical history, conducting a physical examination and gynecological check-up, and performing laboratory tests such as a urine pregnancy test, vaginal cleanliness assessment, tests for trichomoniasis and yeast infections, complete blood count, blood type, and, if necessary, an ultrasound examination.
2.
The doctor provides detailed instructions on how to take the medication, its efficacy, and potential side effects, and medication can only be administered after obtaining consent.
3.
For the first two days, mifepristone is taken orally, followed by misoprostol on the last day.
Patients should fast for two hours before and after taking the medication, and after taking misoprostol on the last day, they should remain in bed, as miscarriage typically occurs within two hours.
The commonly used dosage is 150-200 mg of mifepristone, which can be taken as a single dose or divided over three days.
4.
On the third day, patients should go to the hospital to take a prostaglandin preparation: either a 1 mg misoprostol vaginal insert or 600 mcg of misoprostol orally.
Patients will be observed in the hospital for six hours.
Note: The U.S.
Food and Drug Administration (FDA) has approved the use of mifepristone for abortion up to 49 days of pregnancy.
According to FDA reports, administering 600 mg of mifepristone orally within 49 days of pregnancy, followed by 400 mcg of misoprostol 48 hours later, has a success rate of 92%.

Reply Date: 2017/03/26

More Info

I'm sorry to hear about your situation regarding the embryonic sac atrophy. It's understandably a difficult time, and I hope to provide you with some clarity regarding your medication and the situation at hand.

Embryonic sac atrophy, or the absence of a visible embryo and heartbeat during early pregnancy, can be distressing. This condition often indicates a miscarriage or a non-viable pregnancy. Your healthcare provider's recommendation for medication is likely aimed at managing any discomfort and addressing the situation appropriately.

Regarding the medication you mentioned, "喜克潰定" (likely referring to a medication used to manage gastrointestinal issues, possibly a proton pump inhibitor or similar) and pain relief medications, here are some general guidelines:
1. Dosage of 喜克潰定: If your doctor has prescribed four tablets to be taken at once, it is essential to follow their instructions. The instruction to take four tablets immediately suggests that this is a loading dose intended to provide rapid relief or effect. However, if you have concerns about the dosage or if it seems excessive, it is crucial to clarify this with your healthcare provider before taking the medication.

2. Taking Medication on an Empty Stomach: Many medications, especially those affecting the gastrointestinal tract, may require you to take them on an empty stomach for optimal absorption. However, this can vary based on the specific medication. If the instructions on the medication packaging do not specify, it is best to consult your doctor or pharmacist for personalized advice.

3. Pain Relief Medication: Regarding the pain relief medication, it is common for doctors to recommend taking pain relievers at specific intervals (like every six hours) to maintain a consistent level of pain control in your system. However, if you are experiencing significant pain, it is generally acceptable to take the medication earlier than the recommended interval, as long as you do not exceed the maximum daily dosage. Again, this should be confirmed with your healthcare provider, especially considering your current medical situation.

4. Monitoring Symptoms: While taking these medications, keep a close watch on your symptoms. If you experience any unusual side effects or if your pain worsens, you should contact your healthcare provider immediately.

5. Emotional Support: It's also important to acknowledge the emotional toll that this situation can take. If you find yourself feeling overwhelmed, consider reaching out to a mental health professional or support groups that specialize in pregnancy loss. They can provide valuable support during this challenging time.

In conclusion, while the medications prescribed can help manage your symptoms, it is essential to follow your healthcare provider's instructions closely and communicate any concerns you may have. Your health and well-being are paramount, and your doctor is there to support you through this process. If you have any further questions or uncertainties, do not hesitate to reach out to your healthcare provider for clarification.

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