RU486: What to Expect After Taking the Medication

Post-administration of RU486 related information?

Hello, I would like to ask the following questions.
I took the first dose of medication around 5 weeks into my pregnancy on 9/11 at 16:40 (I have been experiencing persistent nausea and vomiting).
On 9/13 at 7:00, I took the second dose of 2 pills (20 minutes after taking the medication, I started experiencing cramping and diarrhea, and I vomited about 40 minutes later).
At 9:00 on 9/13, I took 1 pill of the second dose (I didn't feel as uncomfortable as before, but about an hour later, I also vomited! I still had cramping and diarrhea, but the amount was not significant.
I took anti-nausea and gastric medication, but before I could take the pain medication, I vomited everything out).
At 10:00 on 9/13, I returned for a follow-up (I hadn't expelled everything yet, but the ultrasound showed a decrease).
That afternoon, the bleeding gradually increased, resembling a menstrual period.
While showering that night, I suddenly expelled three large blood clots.
On 9/15 at 11:00, I returned for another follow-up.
The ultrasound doctor said there were still some remnants inside and that it hadn't been completely expelled.
He prescribed another 2 pills to be taken on Monday morning, and I was to return on Tuesday.
If it wasn't cleared out, they would need to perform suction, as it would be faster.
During this period, I continued to pass small blood clots, with the amount resembling the second day of a menstrual period.
On 9/17 at 8:00, I took two pills again, experiencing cramping and diarrhea, but the nausea and vomiting were less severe! On 9/18 at 9:00, I returned for a follow-up.
The doctor performed another ultrasound and suggested suction again.
It was extremely painful, but they managed to extract some material.
The doctor mentioned that since I had never given birth before, my birth canal had not dilated, making it more difficult to expel everything, but it was very uncomfortable, so we stopped! The doctor said there was still a little left inside and that I would likely need 2-3 more suction procedures to clear it out.
Later, I stayed at the clinic for an IV (it looked like normal saline 0.9% + uterotonics, and then they administered an IM injection for inflammation).
The nurse came in to check because the doctor had placed gauze, but it was all dry.
Later, around 15:00, when they removed the gauze, it was completely soaked, and I had to use a sanitary pad that was also fully wet (the doctor prescribed 6 more pills for me to take on 9/19 and 9/20, 2 pills at 8:00 and 1 pill at 10:00).
I was also prescribed anti-inflammatory medication to take three times a day.
I want to ask if this situation after taking the medication is considered abnormal? Is suction absolutely necessary? I read online that it usually takes about 2 weeks to clear out, but suction is really uncomfortable.
At that moment, I felt like I wanted to harm my husband.
However, since I am still passing some material, is suction the only way to ensure everything is cleared out? Can't it just flow out gradually? The clinic doctor told me that it hasn't cleared out in the past few days, and I might have to endure the pain of suction again on Saturday.
Is this because I have never given birth before? Should I go to the hospital for a check-up? I'm really frustrated, and there's no one to share this with...

Ni, 20~29 year old female. Ask Date: 2018/09/18

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the success rate of medical abortion is approximately 95%, while the failure rate is about 5%.
After taking the abortion medication, patients must return for follow-up within one to two weeks.
Clinical examination, β-HCG testing, and ultrasound scanning are necessary to confirm whether the embryo has been completely expelled.
If there are any other symptoms, further evaluation by a healthcare provider is required to determine if additional interventions are needed.
It is recommended that you discuss your current condition and management options with your attending physician.
Thank you! Wishing you safety and health, Dr.
Zhang.

Reply Date: 2018/09/18

More Info

RU486, also known as Mifepristone, is a medication used for medical abortion, typically in the early stages of pregnancy. Understanding what to expect after taking RU486 is crucial for anyone considering its use, as well as for their partners and support systems. Here’s a comprehensive overview of the medication, its effects, and what to anticipate during the process.

What is RU486?
RU486 is a synthetic steroid that blocks the hormone progesterone, which is necessary for the continuation of pregnancy. It is usually administered in two stages: the first dose is taken at a healthcare facility, followed by a second dose of misoprostol taken at home 24 to 48 hours later. This combination effectively induces a miscarriage.

Expected Effects After Taking RU486
1. Initial Symptoms: After taking RU486, many women experience symptoms such as nausea, vomiting, abdominal cramps, and diarrhea. These symptoms can vary in intensity and duration. In your case, it seems you experienced significant discomfort, including cramping and gastrointestinal upset, which is not uncommon.

2. Bleeding: Following the administration of RU486, bleeding typically begins within a few days. This bleeding can be similar to a heavy menstrual period and may include the passage of blood clots. It is essential to monitor the amount and duration of bleeding. In your situation, it appears that you experienced an increase in bleeding and the passage of blood clots, which is a normal part of the process.

3. Follow-Up Care: It is crucial to have follow-up appointments with your healthcare provider after taking RU486. These appointments allow for monitoring of the abortion process through ultrasound and to ensure that the pregnancy has been terminated completely. If there are indications that tissue remains in the uterus, further intervention may be necessary, such as a suction curettage (D&C).

Concerns About Incomplete Abortion
In cases where bleeding continues or if there are signs of retained products of conception, such as persistent pain or heavy bleeding, a healthcare provider may recommend a surgical procedure to ensure that the uterus is clear. This is particularly important if the ultrasound indicates that not all tissue has been expelled. Your experience of having to undergo suction after taking RU486 is a common concern, especially for those who have not previously given birth, as the cervix may not dilate as easily.

Managing Discomfort and Recovery
1. Pain Management: It is essential to manage pain effectively during this process. Over-the-counter pain relievers or those prescribed by your doctor can help alleviate discomfort.
2. Rest and Recovery: After taking RU486, it is advisable to rest and avoid strenuous activities. Your body is undergoing significant changes, and allowing yourself time to recover is vital.

3. Diet and Hydration: Maintaining a balanced diet and staying hydrated can support your recovery. Avoiding alcohol and certain herbs that may affect uterine contractions is recommended during this time.

4. Emotional Support: The emotional aspect of undergoing a medical abortion can be significant. It is essential to seek support from friends, family, or counseling services if you are feeling overwhelmed.

When to Seek Immediate Medical Attention
If you experience severe pain, heavy bleeding (soaking through two or more pads in an hour for two consecutive hours), fever, or any other concerning symptoms, it is crucial to seek medical attention immediately. These could be signs of complications that require prompt intervention.

Conclusion
In summary, while the experience of taking RU486 can be challenging, understanding what to expect can help alleviate some concerns. It is essential to maintain open communication with your healthcare provider and to attend all follow-up appointments. If you have any doubts or experience unusual symptoms, do not hesitate to reach out for medical advice. Your health and well-being are paramount during this process.

Similar Q&A

Managing Side Effects of Lurasidone: What to Do When You Feel Unwell

Hello Doctor: Yesterday I was prescribed Propranolol, but this morning I was completely unable to function due to dizziness. In the afternoon, I took Ritalin, and by the evening, I felt very fatigued. It seems that the effects of yesterday's medication are wearing off. I nee...

Dr. Lin Mianzhang reply Psychiatry
Hello Ms. Chang: Thank you for your hard work! Many people experience fatigue and drowsiness as side effects from taking Lipitor, which usually improve after a few days to a few weeks of medication. If the discomfort persists, I recommend that you try reducing the dosage by half ...

Understanding Medication Addiction: Coping Strategies and Insights

Dear Dr. Tang, I have been taking Rivotril for two years. Recently, in order to test whether discontinuing this medication would result in any withdrawal symptoms, I intentionally refrained from taking it twice over the past week at my regular medication time (10:30 PM). Both ti...

Dr. Tang Xinbei reply Psychiatry
Dear Youyou, I apologize for the delayed response due to my recent trip abroad for a conference. Rivotril is classified as a sedative, and it is generally not recommended for long-term use. However, many patients may take it continuously for an extended period. When attempting t...

Managing Medication Side Effects: From Agitation to Excessive Sleepiness

Hello, doctor! I am a family member of the patient. The patient was previously hospitalized and experienced restlessness after taking medication (Risperidone 2 mg, two tablets daily). The patient had an outpatient visit yesterday, received an injection, and after changing the dre...

Dr. Wu Enliang reply Psychiatry
Hello, internet user: Please discuss this immediately with your attending physician. Dr. Wu En-Liang.

Understanding Panic Attacks After Starting Antidepressants: What to Know

Hello Doctor: I have issues with anxiety, panic, and PPPD. I visited a doctor last Friday, and the prescription included an antidepressant at 10mg (half a pill daily for the first week, then one pill starting the second week) and Ritalin at 0.5mg (to be used as needed). I did not...

Dr. Wu Enliang reply Psychiatry
Hello, doctor. I would like to ask if my situation indicates that I am not suitable for using antidepressants? A: This episode should not be related to the medication, so it does not mean you are unsuitable for it. The doctor I consulted earlier did not inform me whether this is ...