Post-Medication Abortion: What to Expect After RU486

Post-abortion care following medical abortion?

Hello Doctor, I heard from a friend that RU486 is usually divided into three doses, but I took it in five packets (the doctor said I was four weeks pregnant).
I only know that the first packet is to stop growth, but I'm unclear about the remaining four packets.
The medication schedule was as follows: the first packet was taken on 3/14 at 12:00 PM, and the remaining four packets were taken starting at noon on 3/15, one packet every hour.
After taking the first packet, I started to experience some light bleeding, and I continued to take the remaining medication.
However, after finishing all the doses, I did not experience heavy bleeding or severe cramping like others have described.
My bleeding was very light, almost negligible, and there were no blood clots.
I typically do not experience pain during my menstrual period, and the discomfort from the medication was tolerable, not excessively painful.
During my follow-up appointment on 3/16, the obstetrician mentioned that my uterine contractions were weak and that I had not expelled the contents.
An aspiration procedure was performed, and I was prescribed a three-day course of medication, which included 1.
CEPAHNMYCIN CAPSULES 500MG, 2.
ERGOMETRINE TABLETS 0.2MG, 3.
PARAMOL TABLETS, and 4.
SUWELL TABLETS "EVEREST." Is it normal for the bleeding to still be very light (not even enough to be considered a small amount) after the aspiration procedure? Will I need a second aspiration or a dilation and curettage (D&C)? What should I be aware of moving forward?

Ni Ni, 20~29 year old female. Ask Date: 2020/03/19

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it is normal to experience some bleeding after surgery.
You just need to follow your doctor's instructions and return to the original clinic for follow-up.
Wishing you good health.

Reply Date: 2020/03/19

More Info

After taking RU486 (mifepristone), it is important to understand what to expect during the post-medication abortion process. RU486 is commonly used in combination with another medication, misoprostol, to terminate an early pregnancy. The process typically involves taking RU486 first, followed by misoprostol, which induces uterine contractions to expel the pregnancy tissue.

In your case, it appears that you received a slightly different regimen, taking RU486 in a divided manner over several doses. This can sometimes happen based on the specific protocols of the healthcare provider or the individual circumstances of the patient. The first dose of RU486 works by blocking the hormone progesterone, which is necessary for the pregnancy to continue. The subsequent doses of misoprostol are intended to cause the uterus to contract and expel the pregnancy.

It is not uncommon for individuals to experience varying degrees of bleeding and cramping after taking these medications. Some may have heavy bleeding and significant cramping, while others may have lighter bleeding and minimal discomfort. The fact that you experienced only light bleeding and minimal pain could be due to several factors, including the timing of the medication, your body's response, and the effectiveness of the medications in your specific case.

When you returned to your healthcare provider and they noted that your uterus was not contracting effectively, they performed a suction aspiration procedure to help remove any remaining tissue. This is a common follow-up procedure when the medications do not result in complete expulsion of the pregnancy tissue. After suction aspiration, it is normal for the bleeding to be light, as the procedure itself can help clear the uterus and reduce the amount of tissue that needs to be expelled.

In terms of what to expect after the aspiration, light bleeding is generally considered normal. However, if you experience heavy bleeding (soaking through a pad in an hour), severe pain, or any signs of infection (such as fever, chills, or foul-smelling discharge), you should contact your healthcare provider immediately.
Regarding the need for a second aspiration or a dilation and curettage (D&C), this decision is typically based on follow-up examinations and ultrasound results. If your provider believes that there is still retained tissue or if your bleeding does not resolve, they may recommend further intervention. It is essential to follow up with your healthcare provider as advised to monitor your recovery and ensure that your uterus is healing properly.

In terms of care after the procedure, it is important to:
1. Rest: Allow your body time to recover. Avoid strenuous activities for a few days.

2. Monitor Bleeding: Keep track of your bleeding. Light bleeding can last for a few days to a couple of weeks.

3. Avoid Tampons and Sexual Intercourse: For at least two weeks or until your doctor advises, to reduce the risk of infection.

4. Follow-Up Appointments: Attend all scheduled follow-ups to ensure that your recovery is on track.

In conclusion, while your experience may differ from others, it is essential to communicate openly with your healthcare provider about any concerns you have. They can provide personalized advice and reassurance based on your specific situation. If you have any further questions or experience any concerning symptoms, do not hesitate to reach out to your healthcare provider for guidance.

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