Medication Abortion: Signs of Incomplete Expulsion - Obstetrics and Gynecology

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Understanding medication abortion and recognizing the signs of incomplete expulsion is crucial for ensuring your health and well-being. Based on your description, it seems you have undergone a medical abortion using medication prescribed by your healthcare provider. The process typically involves taking two types of medications: mifepristone and misoprostol. Mifepristone is taken first to block the hormone progesterone, which is necessary for the pregnancy to continue. After a few days, misoprostol is taken to induce contractions and expel the pregnancy tissue.

After taking these medications, it is common to experience bleeding and the passage of blood clots, which can include tissue. However, it is not always possible to visually confirm the expulsion of the embryo or fetal tissue, especially if you did not closely examine the expelled material.
The symptoms you are experiencing, such as nausea, increased frequency of urination, abdominal swelling, and loss of appetite, could indicate several things. It is important to consider the following possibilities:
1. Incomplete Abortion: If the abortion was not complete, remnants of the pregnancy tissue may still be present in the uterus. This can lead to ongoing pregnancy symptoms, as the body may still produce pregnancy hormones. Signs of incomplete abortion can include prolonged bleeding, severe cramping, or persistent pregnancy symptoms.

2. New Pregnancy: Given that you had unprotected intercourse on November 15, it is also possible that you could be experiencing symptoms of a new pregnancy. The timing of your symptoms and the return of certain pregnancy signs, such as nausea and abdominal changes, could suggest this.

3. Hormonal Changes: After a medical abortion, your body undergoes hormonal changes that can affect your mood, appetite, and physical sensations. This can sometimes mimic pregnancy symptoms.

To determine whether you have experienced a complete abortion or if you are potentially pregnant again, it is essential to follow up with your healthcare provider. They may recommend:
- Ultrasound: An ultrasound can help visualize the uterus and confirm whether any tissue remains. This is a reliable method to assess the completeness of the abortion.

- Pregnancy Test: A urine or blood pregnancy test can help determine if you are still pregnant. If the test is positive, it may indicate that you have not expelled the pregnancy tissue completely or that you have conceived again.

- Physical Examination: Your healthcare provider may perform a pelvic exam to check for any signs of complications, such as infection or retained tissue.

In summary, it is crucial to consult with your healthcare provider to address your concerns. They can provide appropriate testing and guidance based on your symptoms and medical history. If you are experiencing any severe symptoms, such as heavy bleeding, severe pain, or fever, seek medical attention promptly. Your health and safety are the top priority, and your provider can help you navigate this situation effectively.