the Use of Uterotonics and Hemostatic Agents After Abortion

Medication Use (Uterotonics and Hemostatics)

Hello Doctor: I underwent a surgical abortion on December 24.
After the procedure, there was minimal bleeding.
On January 29, I experienced light bleeding when my period started, but on January 30, I had a heavy bleed and went to the emergency room.
I was hospitalized for three days, and the bleeding reduced to a small amount.
On February 4, I returned to see the abortion doctor, and a urine test showed a positive pregnancy result, leading to a blood test.
On February 8, I went back for the blood test results, which indicated a pregnancy hormone level of over 1500.
The doctor mentioned that the pre-surgery level was over 20,000, and while a drop to 1500 is acceptable, I continued to experience bleeding, and my endometrium was slightly thickened.
Therefore, I received a chemotherapy injection.
During this time, I passed blood clots twice and continued to have intermittent bleeding.
I experienced lower abdominal pain, which was alleviated with pain medication.
On February 14, the bleeding increased significantly, and following the doctor's instructions, I took hemostatic and uterine contraction medications.
The bleeding decreased, so I stopped taking the hemostatic medication.
On February 15, the bleeding was heavy again, accompanied by many blood clots.
After taking the hemostatic and uterine contraction medications for over two hours, I began to pass blood clots and blood.
After taking the uterine contraction medication that evening, the bleeding reduced significantly.
Should I continue taking the hemostatic and uterine contraction medications until the bleeding stops? Is this bleeding phenomenon normal? Is there a possibility that everything has not been expelled completely? Thank you for your patience in reading this lengthy message.
Thank you.

Miss Hsieh, 30~39 year old female. Ask Date: 2021/02/16

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it is recommended to visit a major hospital for examination and consultation.
Wishing you good health.

Reply Date: 2021/02/16

More Info

After an abortion, it is not uncommon to experience some bleeding and discomfort as your body adjusts and heals. The use of uterotonics (medications that stimulate uterine contractions) and hemostatic agents (medications that help control bleeding) is often necessary to manage these symptoms effectively.
In your case, it seems that you have been experiencing a significant amount of bleeding and discomfort following your procedure. The fact that you had a blood loss episode and were hospitalized indicates that your healthcare providers are taking your situation seriously. The use of medications like uterotonics and hemostatic agents is aimed at ensuring that your uterus contracts properly to expel any remaining tissue and to minimize excessive bleeding.

Uterotonics, such as Ergonovine or Oxytocin, are commonly used after an abortion to promote uterine contractions. These medications help the uterus return to its normal size and can prevent complications such as hemorrhage. However, they can also cause side effects, including abdominal pain, nausea, and sometimes increased bleeding if the uterus contracts too forcefully. It is essential to monitor how your body responds to these medications. If you experience severe pain or excessive bleeding, you should contact your healthcare provider immediately.

On the other hand, hemostatic agents, such as Tranexamic Acid, are used to help reduce bleeding by promoting clot formation. These medications can be particularly beneficial if you are experiencing heavy bleeding or passing blood clots. It is crucial to follow your doctor’s instructions regarding the duration of these medications. Typically, you would continue taking them until your bleeding stabilizes and your healthcare provider advises you to stop.

Regarding your question about whether the bleeding is normal, it is important to understand that some bleeding can be expected after an abortion. However, if the bleeding is heavy, accompanied by large clots, or if you experience severe pain, it may indicate that not all tissue has been expelled or that there is another complication. In such cases, further evaluation, such as an ultrasound, may be necessary to ensure that your uterus is clear.

In summary, it is essential to maintain open communication with your healthcare provider. They can provide personalized advice based on your specific situation. If you are unsure about the medications you are taking or if you should continue them, do not hesitate to reach out to your doctor. They can help you determine the best course of action to ensure your recovery is as smooth as possible. Remember, your health and well-being are the top priority, and it is always better to err on the side of caution when it comes to your health.

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