Is Surgery Necessary After 20 Days of Light Bleeding Post-Miscarriage?

Light bleeding 20 days after a miscarriage?

After a medical abortion, I returned for a follow-up appointment two weeks later, and the pregnancy test still showed faint double lines.
The doctor prescribed contraction medication and asked me to return in five days.
If I still see two lines on the test, I will need to undergo a surgical procedure to clear everything out.
Although there has been some light spotting (slight blood streaks) for about 20 days, is surgery absolutely necessary? Can I wait a bit longer to see if I can naturally pass everything?

Niming, 30~39 year old female. Ask Date: 2017/11/24

Dr. Huang Jianzhong reply Obstetrics and Gynecology

After a medical abortion, I returned for a follow-up appointment two weeks later, and the pregnancy test still showed faint positive lines.
The doctor prescribed contraction medication and asked me to return in five days.
If I still test positive, I will need to undergo a surgical procedure to ensure everything is cleared out, even though there has been some light bleeding (slight spotting) for about 20 days.
Is surgery absolutely necessary? Can I wait a bit longer to see if it will clear naturally? Answer: Yes, you can wait a bit longer to see if it will clear naturally.

Reply Date: 2017/11/24

More Info

After a miscarriage, it is common for women to experience some light bleeding or spotting as the body begins to return to its pre-pregnancy state. In your case, having light bleeding for about 20 days post-miscarriage, along with the presence of faint lines on a pregnancy test, indicates that there may still be some retained products of conception in the uterus. This situation can be concerning, and it is understandable that you are anxious about the need for further surgical intervention.

The decision to proceed with surgery, such as a dilation and curettage (D&C), often depends on several factors, including the amount of bleeding, the presence of symptoms like severe pain or fever, and the results of follow-up examinations. If the bleeding is light and you are not experiencing any other complications, your doctor may suggest waiting a little longer to see if your body can naturally expel any remaining tissue. However, if the pregnancy test continues to show positive results after a certain period, it may indicate that there are still remnants of the pregnancy that need to be addressed.

In general, if the bleeding is minimal and you are not experiencing significant discomfort, it may be reasonable to wait and see if the bleeding resolves on its own. However, it is crucial to closely monitor your symptoms and follow your doctor's advice. If the bleeding increases, or if you develop any concerning symptoms such as fever, chills, or severe abdominal pain, you should seek medical attention immediately.

Your doctor has prescribed medication to help the uterus contract and expel any remaining tissue, which is a common approach in such situations. It is essential to follow up with your doctor as advised, as they will be able to assess your condition more accurately through examinations and possibly an ultrasound to determine if there is any retained tissue.

In summary, while it may be possible to wait and see if your body can clear the remaining tissue naturally, it is essential to maintain open communication with your healthcare provider. They will guide you based on your specific situation and the results of your follow-up appointments. If you have any doubts or concerns, do not hesitate to reach out to your doctor for clarification and support. Your health and well-being are the top priority, and your doctor is there to help you navigate this challenging time.

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