Irregular Bleeding After Medication Abortion: What to Expect

Intermittent bleeding after a miscarriage?

I underwent a medical abortion on March 13 of this year, and I experienced intermittent bleeding until the end of March.
By that time, the bleeding had decreased, and my doctor mentioned that everything appeared to be cleared out.
A pregnancy test showed faint positive lines, and I was advised to continue monitoring.
However, on April 10, I started experiencing heavy bleeding again, which has continued until today (May 4).
I have also been experiencing persistent abdominal pain.
The first week had heavier bleeding, but afterward, it has been consistent with the middle of a 23 cm pad becoming saturated, and I have noticed some membrane-like tissue being expelled.
The pregnancy test still shows two lines.
I would like to know if this indicates that everything has not been cleared out.
If it hasn't been cleared, is surgery necessary? Thank you for your response.

Xiang, 10~19 year old female. Ask Date: 2020/05/04

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it is possible that it hasn't been fully cleared yet.
I recommend returning to the original clinic for continued monitoring.
Wishing you good health.

Reply Date: 2020/05/04

More Info

Irregular bleeding after a medication abortion can be a concerning experience, and it is essential to understand the potential causes and what to expect during the recovery process. Medication abortion typically involves the use of two medications: mifepristone and misoprostol. After taking these medications, it is common for individuals to experience bleeding, which can vary in duration and intensity.

In your case, it appears that you experienced initial bleeding after the abortion, which is expected. The fact that the bleeding was intermittent and then increased again on April 10 suggests that your body may still be in the process of expelling remaining tissue or that there could be other factors at play. The presence of abdominal pain and the passage of membrane-like tissue can indicate that there may still be some retained products of conception, which could lead to ongoing bleeding.

It is crucial to monitor your symptoms closely. If the bleeding is heavy (soaking through a pad in an hour or less for several consecutive hours), accompanied by severe pain, or if you experience any signs of infection (such as fever, chills, or foul-smelling discharge), you should seek medical attention immediately. These symptoms could indicate complications that may require further evaluation and possibly surgical intervention.

Regarding your question about whether retained products of conception necessitate surgery, it depends on the clinical evaluation. If an ultrasound confirms that there are retained tissues and you are experiencing significant symptoms, a healthcare provider may recommend a procedure such as dilation and curettage (D&C) to remove any remaining tissue. However, if the bleeding is manageable and the ultrasound shows that the uterus is clearing out, your doctor may suggest a watchful waiting approach.

It is also important to consider the psychological impact of experiencing prolonged bleeding and pain after an abortion. Emotional support and counseling can be beneficial during this time, as it can be a challenging experience both physically and emotionally.

In summary, while some irregular bleeding after a medication abortion can be normal, ongoing heavy bleeding and pain warrant further investigation. It is essential to maintain open communication with your healthcare provider, follow their recommendations, and attend any follow-up appointments to ensure your health and well-being. If you have any doubts or concerns, do not hesitate to reach out to your doctor for guidance. Your health is paramount, and timely intervention can help prevent complications.

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Hello, you should still follow your doctor's instructions and return to the hospital for a follow-up to see if the miscarriage has been completed. Wishing you good health.