Abnormal Bleeding and Abdominal Pain After Miscarriage

Bleeding abdominal pain?

On June 18, after taking medication for an abortion, I experienced continuous bleeding.
Later, on July 5, the doctor said it was an incomplete abortion and performed a procedure.
A few days prior, the blood volume was low and brownish.
Today, on July 8, when I got up in the morning and squatted to use the toilet, I suddenly had a heavy flow of bright red blood, and my abdomen also hurts.
What could be the reason for this? Is this normal?

Ting, 40~49 year old female. Ask Date: 2017/07/08

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, I apologize for not being able to provide a diagnosis based on what you've described; everything should be normal.
If you continue to experience discomfort, I recommend seeing a gynecologist.
Wishing you good health.

Reply Date: 2017/07/08

More Info

Experiencing abnormal bleeding and abdominal pain after a miscarriage can be concerning and may indicate several underlying issues that require attention. In your case, the timeline you provided suggests that you have undergone a medical abortion that did not go as planned, leading to incomplete evacuation of the uterine contents. This can result in ongoing bleeding and pain, which are common symptoms following such procedures.

When a miscarriage occurs, the body typically expels the pregnancy tissue naturally. However, if this process is incomplete, it can lead to retained products of conception (RPOC). RPOC can cause continued bleeding, which may vary in color from brown (indicating older blood) to bright red (indicating fresh bleeding). The presence of abdominal pain, especially if it is severe, can also indicate that the uterus is contracting to expel the remaining tissue or that there may be an infection or other complications.

In your situation, the sudden increase in bleeding to a bright red color, accompanied by abdominal pain, could suggest several possibilities:
1. Retained Products of Conception: If there are still remnants of the pregnancy tissue in the uterus, it can lead to prolonged bleeding and cramping. This is often treated with a follow-up procedure, such as a dilation and curettage (D&C), to remove any remaining tissue.

2. Infection: If the uterus becomes infected (a condition known as endometritis), it can lead to abnormal bleeding and pain. Symptoms of infection may include fever, foul-smelling discharge, and increased pain. This requires prompt medical evaluation and treatment with antibiotics.

3. Hormonal Changes: After a miscarriage, the body undergoes significant hormonal changes, which can affect menstrual cycles and lead to irregular bleeding. However, this typically does not cause severe pain.

4. Uterine Atony: If the uterus does not contract effectively after a miscarriage, it can lead to heavy bleeding. This condition may require medical intervention to help the uterus contract and reduce bleeding.

Given the symptoms you are experiencing, it is crucial to seek medical attention as soon as possible. A healthcare provider will likely perform a physical examination, possibly including an ultrasound, to assess the uterus for any retained tissue or signs of infection. Blood tests may also be conducted to check for anemia due to blood loss and to monitor hormone levels.

In summary, while some bleeding and discomfort can be expected after a miscarriage, the sudden change to bright red bleeding and abdominal pain you described warrants immediate medical evaluation. It is essential to address these symptoms promptly to prevent complications and ensure appropriate care. Always consult with your healthcare provider for personalized advice and treatment options based on your specific situation.

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