Post-Abortion Bleeding: Irregular Discharge After Surgery

Post-abortion bleeding outside of menstrual periods?

Hello Dr.
Huang: I underwent a surgical abortion on February 23 due to a 7-week fetus with no heartbeat.
My menstruation returned on April 1, and during that time, I experienced intermittent brown spotting (I consulted a doctor, who advised to monitor the situation).
My period ended cleanly on April 9, but on April 11, I suddenly had a small amount of bleeding (dark red, very light, and not thick).
Today, April 12, the bleeding has continued.
Could you please advise what this might indicate and whether I should seek medical evaluation? Thank you!

Xiao Tao, 20~29 year old female. Ask Date: 2019/04/12

Dr. Huang Jianzhong reply Obstetrics and Gynecology

On February 23, a surgical abortion was performed due to the absence of a heartbeat at 7 weeks of gestation.
Menstruation did not return until April 1, with intermittent brown spotting in between (a doctor was consulted, and they advised to monitor the situation).
The menstrual period ended cleanly on April 9, but on April 11, there was a sudden occurrence of light bleeding (dark red, very light, and not thick).
The bleeding has continued today, April 12.
What could be the underlying issue, and should medical evaluation be sought? Answer: Light bleeding can be monitored further.

Reply Date: 2019/04/12

More Info

Post-abortion bleeding and irregular discharge can be concerning for many women, especially after a surgical procedure like a dilation and curettage (D&C) following a miscarriage. Your experience of intermittent brown discharge followed by a sudden onset of light red bleeding is not uncommon, but it does warrant careful consideration.

After an abortion or miscarriage, it is typical for women to experience some degree of bleeding as the body expels the remaining tissue and returns to its normal state. The initial bleeding can vary in color and consistency, often starting as bright red and transitioning to brown as the blood ages. This brown discharge is usually old blood that has taken longer to exit the body. However, the presence of any new bleeding, especially if it is bright red or accompanied by other symptoms, should be evaluated.

In your case, the timeline you provided indicates that you had a period of brown discharge, which is generally considered normal. However, the sudden onset of light red bleeding a few days after your period ended raises some questions. This could be due to several factors:
1. Retained Products of Conception: Sometimes, not all tissue is expelled during the abortion, which can lead to ongoing bleeding. If tissue remains, it can cause intermittent bleeding or spotting.

2. Hormonal Fluctuations: After a miscarriage or abortion, hormonal levels can take time to stabilize. This can lead to irregular bleeding patterns as your body adjusts.

3. Infection: If there is an infection in the uterus, it can cause abnormal bleeding. Symptoms of infection may include fever, foul-smelling discharge, or severe abdominal pain.

4. Cervical or Uterine Issues: Occasionally, the cervix can remain slightly open after a procedure, leading to light bleeding. Additionally, any trauma or irritation to the uterine lining can also cause spotting.

Given that you have experienced a change in your bleeding pattern, it is advisable to consult your healthcare provider for a thorough evaluation. They may perform a pelvic exam, ultrasound, or other tests to determine the cause of your symptoms. It is essential to rule out any complications, especially if the bleeding persists or worsens.

In summary, while some irregular bleeding can be normal after an abortion, any new or concerning symptoms should be addressed with your healthcare provider. They can provide the necessary guidance and treatment to ensure your recovery is on track. Remember, your health and peace of mind are paramount, so do not hesitate to seek medical advice when in doubt.

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