Medication Abortion: What to Expect After RU486 Use

Medication abortion

Hello, I found out I was 5 weeks pregnant on October 2nd.
I took the first dose of RU486 on October 4th and the second dose on October 6th.
When I returned to the obstetrics and gynecology clinic on October 7th, an ultrasound showed that the embryo was no longer visible.
The doctor then prescribed me uterotonics.
During a follow-up visit on October 16th, it was noted that there was still a 1 cm blood clot that had not been expelled.
However, on October 17th, I noticed a long tissue-like substance, approximately 4 to 5 cm in length, when I went to the bathroom.
I would like to know what this might be.

Lü Lü, 20~29 year old female. Ask Date: 2021/10/18

Dr. Cai Yonglong reply Obstetrics and Gynecology

The first to be expelled should be the fetal tissue, and what was expelled on 10/17 may be chorionic tissue (which will later develop into the placenta).
If there is still pain or bleeding, it is advisable to visit a gynecology clinic.

Reply Date: 2021/10/18

More Info

RU486, also known as Mifepristone, is a medication used for medical abortion. It is typically administered in two stages: the first dose is taken to block the hormone progesterone, which is necessary for the pregnancy to continue, and the second dose, usually taken 24 to 48 hours later, is a prostaglandin (often Misoprostol) that induces uterine contractions to expel the pregnancy tissue.
After taking RU486, it is common to experience a range of symptoms, including cramping, bleeding, and sometimes nausea or vomiting. The cramping can be quite intense as the uterus contracts to expel the contents. It is important to note that while some bleeding is expected, heavy bleeding or passing large clots can indicate complications, such as incomplete abortion or infection, and should be evaluated by a healthcare provider.

In your case, after taking the second dose of RU486, you experienced bleeding and passed what you described as a long tissue-like structure. This could likely be the pregnancy tissue that your body is expelling. It is not uncommon for women to pass clots or tissue after a medical abortion, especially if there was a significant amount of tissue present. The size you mentioned (4-5 cm) is within the range of what can be expected during this process.

It is crucial to follow up with your healthcare provider after a medical abortion to ensure that the process is complete and to check for any complications. The ultrasound you had on 10/7 indicated that the embryo was no longer visible, which is a positive sign that the medication is working. However, the presence of a 1 cm blood clot on 10/16 suggests that not all tissue may have been expelled at that time.
If you are experiencing significant pain, heavy bleeding (soaking through two or more pads in an hour), or fever, you should seek medical attention immediately. Your healthcare provider can perform an examination, which may include an ultrasound or pelvic exam, to assess your condition and ensure that there are no retained products of conception or other complications.

In summary, after using RU486, it is essential to monitor your symptoms closely and maintain communication with your healthcare provider. Passing tissue can be a normal part of the process, but any concerning symptoms should be addressed promptly to ensure your health and well-being. Always follow the guidance of your healthcare provider regarding follow-up appointments and any additional medications that may be necessary to complete the abortion process safely.

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