Post-Abortion Complications and Concerns - Obstetrics and Gynecology

Questions about miscarriage?

Hello, I took the abortion pill RU486 on October 9 to terminate a pregnancy of about 5 weeks.
After taking the second pill on October 11, I started bleeding.
During a follow-up ultrasound on October 13, it was confirmed that the embryo had completely expelled, but there was still a significant amount of blood remaining.
The bleeding stopped by October 20, and the doctor informed me that my menstrual period would likely return around November 15.
However, on October 28, I experienced bleeding again, which was heavier than my usual menstrual flow and lasted about 5 to 6 days, gradually decreasing.
As of today, November 11, I still have some light brown discharge, but I am not experiencing any pain.

During my follow-up appointment on the evening of November 10, the ultrasound indicated that there was still a small amount of embryonic tissue remaining, and a urine test showed a positive result.
How could this happen? On October 13, I was told everything had been expelled, but now on November 10, I am being told otherwise.
I asked the doctor, and he said that since it did not clear completely, I would need to undergo a surgical procedure to remove the remaining tissue.
I have anemia, so the process is taking longer.

After the abortion, my boyfriend and I had sexual intercourse, always using protection, except for one instance on November 4 when he ejaculated inside me.
Could this result in pregnancy? We are both 25 years old and have not yet stabilized our finances; my boyfriend has just recently enlisted, which is why we decided to terminate the pregnancy.
However, I am now hesitant about undergoing surgery.
Are there no other options? Additionally, why are the doctor's statements inconsistent? I am seeing the same well-known obstetrician-gynecologist, not a clandestine practitioner.

On the night of November 10, after the examination revealed signs of pregnancy, I bought a home pregnancy test on my way home and tested myself, which showed only one line, indicating no signs of pregnancy.
What is going on? Can the doctor help clarify this for me? I am currently taking iron supplements and uterine contraction medications, and I have another follow-up appointment next Monday.
I am very anxious about the issue of incomplete expulsion.
What should I do? Thank you.

Xiao Xiong, 20~29 year old female. Ask Date: 2008/11/11

Dr. Dai Qihan reply Obstetrics and Gynecology

I cannot comment directly without conducting relevant tests.
I recommend that you visit a center or hospital for a re-examination.

Reply Date: 2008/11/11

More Info

Post-abortion complications can be a source of significant concern for many individuals, especially after a medical abortion using medications like RU486. Based on your description, it appears that you have experienced some common post-abortion symptoms, but there are also some complications that need to be addressed.

Firstly, it is important to understand that after a medical abortion, it is normal to experience bleeding, which can last for several days to weeks. The bleeding you experienced from October 11 to October 20 is within the expected range. However, the reappearance of bleeding on October 28, which was heavier than your usual menstrual flow, raises some concerns. The presence of coffee-colored blood can indicate older blood, which may suggest that your body is still expelling remnants of the pregnancy.

The ultrasound on November 10 indicating a small amount of retained tissue is significant. Retained products of conception can lead to complications such as infection or prolonged bleeding. Your doctor’s recommendation for a surgical procedure to remove any remaining tissue is a common approach in such cases. While you may feel apprehensive about undergoing another procedure, it is crucial to consider the potential risks of not addressing retained tissue, which can include severe bleeding, infection, and complications related to anemia, especially since you mentioned having anemia.

Regarding your concerns about pregnancy after having unprotected intercourse on November 4, it is possible to conceive if ovulation occurs shortly after the abortion. However, since you have been experiencing bleeding and your recent pregnancy tests have shown negative results, it is likely that you are not pregnant at this time. The discrepancy between the ultrasound findings and your home pregnancy test could be due to the presence of residual pregnancy hormones (hCG) in your system, which can take time to clear after an abortion.

In terms of alternatives to surgical intervention, some options may include monitoring your symptoms closely and allowing your body more time to expel any remaining tissue naturally. However, this should only be done under the guidance of your healthcare provider, as they can assess your specific situation and provide tailored advice.

It is understandable to feel confused and anxious, especially when receiving varying information from your healthcare provider. It is essential to communicate openly with your doctor about your concerns and seek clarification on any points that are unclear. If you feel uncertain about the advice you are receiving, consider seeking a second opinion from another qualified healthcare provider.

In summary, it is crucial to follow up with your healthcare provider regarding the retained tissue and your ongoing symptoms. While the idea of surgery may be daunting, it is often the safest option to prevent further complications. Continue taking your iron supplements and uterine contraction medications as prescribed, and ensure you attend your follow-up appointments for monitoring. Your health and well-being are paramount, and addressing these issues promptly will help you recover more effectively.

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