Postpartum Abdominal Pain: Concerns After Miscarriage and Retained Tissue

Postpartum abdominal pain

Hello, last month at the end of January, I was five months pregnant when during a prenatal check-up, it was discovered that the fetus had died in utero.
I underwent induction to deliver the fetus.
After experiencing lochia for over a week, the bleeding subsided, but I have been feeling cramping in my uterus.
I went to a large hospital for a transvaginal ultrasound, which revealed that there are still remnants in my uterus.
I am unsure if this could be incomplete placental tissue or blood clots.
The physician I consulted didn't provide much explanation, only mentioning that I would need surgery to remove it.
I am a bit worried; if this is not addressed promptly, could it cause more damage to my uterus? If there is still a small amount of placental tissue remaining in the uterus, will I continue to experience bleeding? However, I have hardly had any bleeding.
Could it be that consuming too much alcohol-containing supplements while eating sesame oil kidney dishes has caused my uterus to contract completely, leading to incomplete expulsion? If the expulsion is incomplete now, will it affect my menstrual cycle, potentially preventing ovulation and causing my period to be absent? Are there any other methods besides surgery to ensure complete evacuation? Thank you!

00000, 20~29 year old female. Ask Date: 2019/02/22

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Last month, at the end of the month, I was five months pregnant.
During a prenatal check-up, it was discovered that the fetus had died in utero, and I underwent induction to deliver.
After experiencing lochia for over a week, the bleeding subsided, but I have been feeling cramping in my uterus.
I went to a large hospital for a transvaginal ultrasound, which revealed that there are still remnants inside the uterus.
I am unsure if this could be incomplete placental tissue or blood clots.

The doctor during the examination didn't say much, only that I would need surgery to remove it, but I am still a bit worried.
If not addressed in a timely manner, could this cause further damage to the uterus? After the lochia subsided for over a week, if there is still a small amount of placental tissue remaining in the uterus, will I continue to bleed?
If there is still a small amount of placental tissue left in the uterus, it could lead to ongoing bleeding, but I have hardly experienced any bleeding.
Could it be that consuming too much alcohol-containing supplements while eating sesame oil kidney dishes has caused my uterus to contract completely, leading to incomplete expulsion?
If the expulsion is incomplete now, will it affect my menstrual cycle, potentially preventing ovulation and causing my period to be absent? Is there no other method besides surgery that could effectively clear it out? The situation can be monitored further.

Reply Date: 2019/02/22

More Info

Postpartum abdominal pain, especially after a miscarriage, can be a concerning issue for many women. It’s important to understand the potential causes and implications of retained tissue in the uterus and how it can affect your recovery and future reproductive health.

When a miscarriage occurs, particularly in the second trimester, there can be complications such as retained products of conception (RPOC). This means that some tissue from the pregnancy, such as placental tissue, may not have been expelled from the uterus during the miscarriage. This can lead to various symptoms, including abdominal pain, prolonged bleeding, or even infection if not addressed promptly.

In your case, the ultrasound indicating that there is still something in the uterus suggests that you may have RPOC. The presence of retained tissue can indeed cause continued cramping or pain as the uterus attempts to contract and expel the remaining tissue. If the tissue is not removed, it can lead to complications such as heavy bleeding, infection, or even more serious conditions like uterine atony, where the uterus fails to contract properly after delivery or miscarriage.

Regarding your concerns about whether retained tissue will lead to continuous bleeding, it is possible. If the tissue remains, it can disrupt the normal healing process of the uterus and may lead to irregular bleeding patterns. However, not all women with RPOC experience heavy bleeding; some may have minimal or no bleeding at all, which can be misleading.

As for your question about whether consuming certain foods or supplements could affect the uterus's ability to contract and expel tissue, while a balanced diet is important for recovery, there is no strong evidence to suggest that specific foods like sesame oil or alcohol-containing supplements would directly cause retained tissue. However, it is crucial to maintain a healthy diet to support your overall recovery.

If your doctor has recommended a surgical procedure to remove the retained tissue, it is generally the most effective and immediate way to resolve the issue. Surgical intervention, such as dilation and curettage (D&C), can help clear the uterus and prevent complications. While some women may hope for a natural resolution, it is essential to weigh the risks of leaving retained tissue untreated, which can lead to more significant health issues.

In terms of your future menstrual cycle and ovulation, retained tissue can indeed affect your menstrual regularity. If the uterus is not cleared of all tissue, it may take longer for your body to return to its normal hormonal balance, potentially delaying ovulation and menstruation. However, once the retained tissue is removed, most women can expect their menstrual cycles to normalize within a few months.

In summary, it is crucial to follow your doctor's advice regarding the surgical removal of retained tissue. While it may seem daunting, addressing the issue promptly can help ensure a smoother recovery and better reproductive health in the future. If you have concerns about the procedure or your recovery, do not hesitate to discuss them with your healthcare provider, who can provide personalized guidance based on your specific situation.

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