Is It Normal to Have Blood Clots During Your Second Period After Miscarriage?

The second menstrual period after a miscarriage has blood clots?

Hello doctor, I underwent a dilation and curettage (D&C) procedure in mid-April due to a fetal congenital defect issue.
I had my first menstrual period on May 17, which was normal in flow and color, with no blood clots.
However, last week on Friday (June 16), I had my second menstrual period, and the flow on the second and third days was noticeably heavier than the last time.
Additionally, after using the restroom, I passed a blood clot approximately 2 centimeters long, and over the past few days, I have passed a total of four such clots.
Is this situation normal, or is there a problem? In early May, I had a pelvic exam, and the doctor mentioned that my uterus was clear, but there was a 1.4-centimeter cyst on my left ovary (the doctor said this cyst is a normal occurrence after ovulation and advised not to worry about it).
I would like to know if passing blood clots like this is normal.
Thank you.

Bella, 20~29 year old female. Ask Date: 2017/06/20

Dr. Huang Jianzhong reply Obstetrics and Gynecology

In mid-April, I underwent a dilation and curettage (D&C) procedure due to fetal congenital defects.
On May 17, I had my first menstrual period, which was normal in flow and color, with no blood clots.
However, last week on Friday (June 16), I started my second menstrual period, and the flow on the second and third days was noticeably heavier than the previous month.
Additionally, after using the restroom, I passed a blood clot approximately 2 centimeters long, and over the past few days, I have passed a total of four such clots.
Is this situation normal, or is there a problem? Is it normal to have blood clots?
Answer: It should not be a concern.

P.S.
I had a pelvic examination in early May, and the doctor mentioned that my uterus was clear, but there was a cyst about 1.4 centimeters on my left ovary, which the doctor said is a normal occurrence after ovulation and advised me not to worry about it.

Reply Date: 2017/06/20

More Info

Experiencing blood clots during your menstrual cycle after a miscarriage can be concerning, and it's understandable to seek clarity on whether this is normal. After a miscarriage, the body undergoes several changes as it returns to its pre-pregnancy state. The first few menstrual cycles can be particularly irregular, and variations in flow and clotting can occur.

In your case, you mentioned that your first period after the miscarriage was normal in terms of flow and color, which is a positive sign. However, during your second period, you experienced a heavier flow and the passage of blood clots, measuring about 2 centimeters in length. It’s important to note that blood clots can be a normal part of menstruation, especially if the flow is heavier than usual. Clots are formed when blood pools in the uterus and then thickens before being expelled.
Typically, small clots (less than 3 centimeters) can be considered normal, especially if they are accompanied by a heavier menstrual flow. However, if you are experiencing larger clots, or if the bleeding is excessively heavy (soaking through a pad or tampon every hour for several consecutive hours), it could indicate a potential issue that may require medical attention.
Given that you had a D&C (dilation and curettage) procedure, it is crucial to monitor your symptoms closely. If you notice any of the following, you should consult your healthcare provider:
1. Excessive Bleeding: If you are soaking through pads or tampons every hour for more than a couple of hours.

2. Severe Pain: If you experience significant abdominal pain or cramping that is not relieved by over-the-counter pain medications.

3. Foul Odor: If there is a foul smell associated with the discharge, which could indicate an infection.

4. Persistent Symptoms: If the heavy bleeding and clotting persist for more than a few cycles.

Your mention of a 1.4 cm cyst on your ovary is also relevant. Functional ovarian cysts are common and usually resolve on their own without treatment. However, if you experience any changes in your menstrual cycle or additional symptoms, it may be worth discussing with your doctor to ensure that the cyst is not causing any complications.

In summary, while passing small blood clots during your second period after a miscarriage can be normal, it is essential to remain vigilant about your symptoms. If you have any concerns about the heaviness of your flow, the size of the clots, or any accompanying symptoms, it is advisable to reach out to your healthcare provider for further evaluation. They may recommend an ultrasound or other tests to ensure that everything is progressing normally and that there are no retained products of conception or other complications.
In the meantime, maintaining a healthy lifestyle, managing stress, and allowing your body time to heal can be beneficial as you navigate this recovery period. Remember, every woman's body is different, and it may take a few cycles for your menstrual pattern to stabilize after a miscarriage.

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