Abdominal Pain and Discomfort After Prostaglandin Use - Obstetrics and Gynecology

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After taking RU486 (Mifepristone) and prostaglandins for a medical abortion, experiencing abdominal pain, nausea, and lower back discomfort is relatively common. These symptoms are typically associated with the process of the uterus contracting to expel its contents. Prostaglandins are used to induce contractions and facilitate the abortion process, which can lead to cramping and discomfort similar to menstrual cramps.


Understanding Abdominal Pain and Discomfort
1. Nature of Pain: The abdominal pain you are experiencing is likely due to uterine contractions. As the uterus contracts, it can cause cramping that may radiate to the lower back, resulting in the sensation of lower back pain or discomfort. This is a normal response as the body undergoes the changes associated with the abortion process.

2. Nausea: Nausea can also be a side effect of the medications used. RU486 can cause gastrointestinal upset, and prostaglandins can further exacerbate this effect. It is important to stay hydrated and rest as much as possible during this time.

3. Lower Back Pain: The lower back pain you mentioned can be concerning, but in the context of medical abortion, it is often a result of the same contractions that cause abdominal pain. However, if the pain becomes severe or is accompanied by other symptoms such as heavy bleeding, fever, or foul-smelling discharge, it is crucial to seek medical attention immediately.


When to Seek Medical Attention
While some discomfort is expected, certain symptoms warrant immediate medical evaluation:
- Severe Pain: If the abdominal or back pain becomes unbearable or does not improve with over-the-counter pain relief, it is essential to consult a healthcare provider.

- Heavy Bleeding: If you soak through two or more pads in an hour for two consecutive hours, this could indicate a complication that requires medical intervention.

- Fever: A fever over 100.4°F (38°C) may suggest an infection, which needs prompt treatment.

- Foul-smelling Discharge: This could indicate an infection and should be evaluated by a healthcare professional.


Pain Management
For managing pain, it is generally advised to use acetaminophen (Tylenol) for mild to moderate pain relief. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can also be effective, but they should be used cautiously, especially if you have any contraindications or if your healthcare provider has advised against them.


Conclusion
In summary, abdominal pain and lower back discomfort after taking RU486 and prostaglandins are common and typically manageable. However, it is crucial to monitor your symptoms closely and seek medical attention if you experience any concerning signs. Always follow the guidance of your healthcare provider regarding medication use and symptom management during this process. Your health and well-being are paramount, and open communication with your healthcare team will ensure you receive the best care possible.