Concerns After Taking RU486: Side Effects and Next Steps - Obstetrics and Gynecology

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After taking RU486 (mifepristone) and the subsequent doses of medication prescribed to help expel remaining tissue, it is understandable to have concerns about side effects and the effectiveness of the treatment. RU486 is commonly used in medical abortions and works by blocking the hormone progesterone, which is necessary for pregnancy to continue. The follow-up medication, usually misoprostol, is given to help the uterus contract and expel the pregnancy tissue.

In your girlfriend's case, the doctor noted that while the embryo had been expelled, some chorionic tissue remained in the uterus. This is not uncommon, and the additional medication is intended to facilitate the complete expulsion of any remaining tissue.
Regarding the side effects, experiencing lower back pain after taking the medication can be a common symptom. This pain may be due to the uterine contractions that the medication induces as it works to expel the remaining tissue. However, the absence of bleeding during this time can be concerning. It is important to note that while some women may experience bleeding as a sign that the medication is working, others may not bleed significantly or at all, especially if the tissue is being expelled without heavy bleeding.

Here are some key points to consider:
1. Pain Management: If the back pain is mild, it may be manageable with over-the-counter pain relief, but if it becomes severe or is accompanied by other symptoms such as heavy bleeding, fever, or severe cramping, it is crucial to seek medical attention.

2. Monitoring Symptoms: It is essential to monitor for any signs of complications, such as heavy bleeding (soaking through two pads in an hour for two consecutive hours), severe abdominal pain, fever, or foul-smelling discharge. If any of these occur, immediate medical evaluation is necessary.

3. Follow-Up Care: It is vital to have follow-up appointments with the healthcare provider to ensure that the uterus is clear of any remaining tissue. An ultrasound may be performed to confirm that there are no retained products of conception.

4. Emotional Support: Undergoing a medical abortion can be an emotionally challenging experience. It is important for both partners to seek support from healthcare providers, counselors, or support groups if needed.

5. Future Contraception: After the procedure, discussing future contraceptive options with a healthcare provider can help in planning and preventing unintended pregnancies.

In summary, while back pain can be a normal side effect of the medication, the lack of bleeding does warrant monitoring. It is always best to communicate openly with the healthcare provider about any concerns or unusual symptoms. They can provide the most accurate guidance based on your girlfriend's specific situation and medical history.