Is It Normal to Switch from Medical Abortion to Vacuum Aspiration?

Is it normal to switch from a medical abortion to suction aspiration if the medical abortion fails?

On January 25, after taking RU486, the next morning the doctor instructed me to take the first pack of uterine contraction medication.
After taking it, I was in so much pain that I was shaking, but I still did not start bleeding.
It wasn't until the afternoon that I began to slowly pass some blood, but it was very little.
Even after finishing the second pack of uterine contraction medication, there was still no significant bleeding.
On January 27, during a follow-up ultrasound, it was discovered that the embryo was still present.
The doctor told me that it was due to my poor absorption.
On January 28, I opted for surgery in the morning, but I am uncertain about the safety of the procedure and whether there might be any complications or side effects.
This is my first experience with both medical and surgical abortion, and I am unsure if it will affect my future pregnancies.

Han, 20~29 year old female. Ask Date: 2023/01/27

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, since the medication is ineffective, surgery is the only option.
Generally, the surgery is safe and typically does not affect future pregnancies.
Wishing you good health.

Reply Date: 2023/01/27

More Info

Switching from a medical abortion to vacuum aspiration (also known as suction curettage) is a common practice in situations where the medical abortion does not result in complete expulsion of the pregnancy tissue. In your case, it seems that the initial medical abortion using RU486 (mifepristone) and the subsequent uterine contraction medication did not lead to the desired outcome, as confirmed by the ultrasound showing that the embryo was still present.
Medical abortions typically involve taking two medications: mifepristone, which blocks the hormone progesterone necessary for pregnancy continuation, and misoprostol, which induces uterine contractions to help expel the pregnancy. While many women successfully complete the abortion process with these medications alone, there are instances where the body does not respond adequately, leading to incomplete abortion. This can occur for various reasons, including individual physiological differences, the timing of the medications, or the gestational age of the pregnancy.

When a medical abortion is not successful, healthcare providers may recommend a surgical procedure like vacuum aspiration. This procedure is generally considered safe and is performed in a clinical setting. It involves using a suction device to remove the remaining pregnancy tissue from the uterus. The procedure is typically quick, often taking only a few minutes, and is usually done under local anesthesia or sedation, depending on the patient's preference and the healthcare provider's recommendation.

Regarding your concerns about safety and potential complications, vacuum aspiration is a well-established procedure with a low risk of serious complications when performed by a qualified healthcare professional. Common side effects may include cramping, bleeding, and, in some cases, infection. However, serious complications are rare. It is essential to follow your healthcare provider's post-procedure instructions to minimize risks and ensure proper recovery.

As for the impact on future pregnancies, most women who undergo a vacuum aspiration do not experience long-term fertility issues. The procedure is designed to be minimally invasive, and the uterus typically heals well afterward. However, it is crucial to discuss any concerns with your healthcare provider, who can provide personalized advice based on your medical history and current health status.

In summary, transitioning from a medical abortion to vacuum aspiration is a standard practice when the medical method is ineffective. Vacuum aspiration is generally safe and has a low risk of complications, and it should not significantly affect your future fertility. If you have any lingering concerns or questions about the procedure or its implications, do not hesitate to reach out to your healthcare provider for further clarification and support. They can provide you with the most accurate information tailored to your specific situation.

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Hello, it should be monitored. If you still feel unwell, it is advisable to return to the hospital for a consultation. Generally, it does not affect future pregnancies. Wishing you good health.