Post-Abortion Bleeding: Your Symptoms and Next Steps - Obstetrics and Gynecology

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Post-abortion bleeding can be a concerning experience for many women, especially when accompanied by various symptoms. In your case, it seems you have undergone a medical abortion due to a non-viable pregnancy, and you are experiencing ongoing bleeding and changes in discharge. Let's break down your situation and address your questions.

1. Understanding the Bleeding: After an abortion, it is common to experience bleeding that can vary in color and consistency. The initial bleeding may be bright red, indicating fresh blood, and can transition to darker shades as the body expels remaining tissue. The presence of coffee-colored discharge often signifies older blood that has taken longer to exit the uterus. Given that you have experienced both bright red blood and yellow discharge, it is essential to differentiate whether this bleeding is part of your normal recovery or if it indicates retained products of conception (RPOC).

The fact that you are still testing positive for beta-hCG (40.1) suggests that there may still be some pregnancy tissue remaining in your uterus. Typically, after a complete abortion, beta-hCG levels should drop to zero within a few weeks. If the levels remain elevated, it may indicate that not all tissue has been expelled, which can lead to continued bleeding and potential complications.

2. Next Steps: Given your symptoms and the ongoing bleeding, it is crucial to consult with your healthcare provider. Here are some potential steps you might consider:
- Return to Your Doctor: Since you are experiencing increased bleeding and have a positive beta-hCG test, it is advisable to return to your healthcare provider for further evaluation. They may perform an ultrasound to check for any retained tissue in the uterus. If RPOC is confirmed, they may recommend a surgical procedure (like a dilation and curettage, D&C) to remove the remaining tissue.

- Medication: If your doctor determines that there is no significant retained tissue, they may prescribe medications to help your uterus contract and expel any remaining products. This could include uterotonics, which help the uterus contract more effectively.

- Monitoring Symptoms: If your doctor advises you to monitor your symptoms, keep track of the amount and color of bleeding, any clots, and any associated symptoms like pain or fever. If you experience heavy bleeding (soaking through a pad in an hour), severe pain, or fever, seek medical attention immediately.

- Hormonal Treatment: Regarding your question about using progesterone (黄体素) to induce menstruation, this is sometimes considered if there is a need to regulate the menstrual cycle. However, it is essential to discuss this option with your healthcare provider, as they will consider your specific situation and the potential risks involved.

3. Emotional and Physical Recovery: It’s also important to acknowledge the emotional and physical toll that an abortion can take. Many women experience a range of emotions, including sadness, relief, or anxiety about future pregnancies. Support from friends, family, or counseling can be beneficial during this time.

In summary, your ongoing bleeding and the presence of beta-hCG indicate that further evaluation is necessary. Please consult your healthcare provider for a thorough assessment and appropriate management. They will guide you on the best course of action based on your specific circumstances. Remember, it’s essential to prioritize your health and well-being during this recovery period.