Post-Abortion Complications: Pain and Bleeding Issues

Post-abortion issues

Hello! I visited the doctor on February 22 and was found to be about 4 weeks pregnant, so I opted for medication to induce a miscarriage.
I took the first dose on February 24 and the second dose on February 26 (neither were taken in a hospital).
After that, I experienced intermittent bleeding, sometimes heavy enough to saturate a pad within an hour, continuing until March 29.
I saw the doctor multiple times during this period, but they indicated that it was not completely resolved and that it would improve in a few days.
However, the bleeding persisted, and I experienced abdominal pain.
Finally, on March 29, the bleeding stopped, but the pain continued to trouble me.
I had intercourse after the bleeding ceased (on April 1-3 and April 14-15), and the pain persisted until April 22.
I consulted a doctor who stated that there was no inflammation, the uterus appeared normal, and there was no blood, but the right ovary could not be visualized due to insufficient hydration.
A pregnancy test was conducted, which was negative, but on April 24, I experienced bleeding again, though it was uncertain if it was menstruation (my menstrual cycle lasts 3 days and is expected around April 30).
The bleeding on the 24th and 25th was light and had a pinkish color (there was no blood when lying down), which did not resemble typical menstrual blood, but it continued until today.
On the morning of the 26th, there was no bleeding, but in the evening, there was a sudden increase in flow, exceeding the amount of a normal period, regardless of whether it was 1-3 days.
Additionally, I have ongoing abdominal pain.

1.
What could be the cause of the persistent pain?
2.
How long might the pain continue?
3.
Will this affect future pregnancies?
4.
Is this bleeding due to pregnancy, a miscarriage, or menstruation?

Yue, 20~29 year old female. Ask Date: 2023/04/27

Dr. Huang Yuande reply Obstetrics and Gynecology

1.
The pain may be associated with inflammation or infection, and there could be incomplete expulsion of contents.
2.
A physician should be consulted for an examination to determine whether treatment is necessary or if monitoring is sufficient.
3.
This depends on whether the underlying cause has been addressed.
4.
This could be due to hormonal interference, or there may be residual embryonic tissue, which is difficult to assess based solely on text.

Reply Date: 2023/04/27

More Info

Post-abortion complications can be quite complex and concerning, especially when symptoms like persistent bleeding and abdominal pain occur. Based on the details you provided, it seems you have been experiencing a range of symptoms following a medical abortion, which can include prolonged bleeding, pain, and uncertainty about the nature of your bleeding.

1. Causes of Persistent Pain: The ongoing abdominal pain you are experiencing could be attributed to several factors. After a medical abortion, it is not uncommon for some women to experience cramping and discomfort as the uterus contracts and expels any remaining tissue. However, if the pain is severe or persistent, it may indicate complications such as retained products of conception, which can lead to infection or inflammation. Other potential causes could include ovarian issues, such as cysts or other complications related to the ovaries, especially since you mentioned that the right ovary was not fully examined. Additionally, hormonal fluctuations following an abortion can also contribute to abdominal discomfort.

2. Duration of Pain: The duration of pain can vary significantly from person to person. In many cases, post-abortion pain should gradually decrease over time as the body heals. However, if the pain persists beyond a few weeks or worsens, it is crucial to seek further medical evaluation. Your healthcare provider may recommend imaging studies, such as an ultrasound, to check for any retained tissue or other abnormalities that could be causing the pain.

3. Impact on Future Pregnancies: Generally, if a medical abortion is performed without complications, it should not adversely affect future pregnancies. However, if there are complications such as infections or retained tissue, these could potentially impact future fertility. It is essential to address any ongoing issues promptly to ensure that your reproductive health is not compromised.

4. Nature of Bleeding: The bleeding you are experiencing could be a mix of post-abortion bleeding and potential menstrual bleeding. After an abortion, it is common for women to experience irregular bleeding patterns as the body readjusts. The fact that you have had varying amounts of bleeding, including heavier episodes, suggests that your body is still in the process of returning to its normal cycle. The pink color and lighter flow you described could indicate that it is not typical menstrual bleeding but rather residual bleeding from the abortion. However, the sudden increase in bleeding volume could also warrant further investigation to rule out any complications.

In conclusion, it is essential to maintain open communication with your healthcare provider regarding your symptoms. If you continue to experience significant pain or abnormal bleeding, further evaluation is necessary to rule out complications such as retained products of conception, infection, or other underlying conditions. Regular follow-up appointments can help monitor your recovery and ensure that any potential issues are addressed promptly. Always prioritize your health and seek immediate medical attention if you experience severe symptoms or have concerns about your recovery process.

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