Post-Abortion Abdominal Cramps: When to Seek Medical Attention

Abdominal cramping after an abortion?

Hello, doctor.
I had a surgical abortion about a week ago, approximately five weeks into the pregnancy.
I experienced bleeding on the day of the procedure and the following day, but there were no further issues until the sixth day when I began to have abdominal pain (similar to menstrual cramps on the second day) and noticed fresh red blood.
I visited a doctor that day, and after an ultrasound, they said everything looked fine and prescribed anti-inflammatory and pain relief medication.
On the seventh day, the bleeding gradually decreased, but I still had abdominal pain.
By the eighth day, there was only a faint trace of blood when I wiped after using the restroom, but the abdominal pain changed to a cramping sensation.

After taking two packets of the medication prescribed post-surgery, I woke up the next day with significant facial swelling, so I went to another obstetrics and gynecology clinic.
Since I lost the prescription, the doctor was concerned it might be an allergic reaction to the uterine contraction medication, so they did not prescribe any uterine contraction medication, only anti-inflammatory and pain relief medication.

I would like to ask if this situation is still within the normal range, or if there could be another cause for these symptoms.
Is it possible that not taking the uterine contraction medication is contributing to this? The doctor mentioned that it’s fine not to take it and that the uterus will gradually expel.
Should I perform uterine massage? Currently, it is the eighth day, and I am continuing to monitor my condition.
If I return to the clinic for a follow-up, should I ask the doctor to check for any signs of inflammation? What else should I be aware of? Thank you for your response.

Xiao Hui, 30~39 year old female. Ask Date: 2015/07/27

Dr. Lin Manying reply Obstetrics and Gynecology

After an abortion procedure, it is important to monitor for bleeding and lower abdominal pain.
If symptoms persist, it is advisable to return to the clinic for an examination.
As for drug allergies, it is necessary to review the medication list to make any assumptions; pain relievers and antibiotics are commonly associated with allergic reactions.

Reply Date: 2015/07/27

More Info

After undergoing an abortion, it is not uncommon to experience some abdominal cramps and bleeding as your body adjusts. However, it is crucial to monitor these symptoms closely, as they can indicate potential complications. In your case, you mentioned experiencing abdominal pain that resembles menstrual cramps, along with fresh red bleeding starting on the sixth day post-procedure. While some discomfort can be expected, there are specific signs that warrant immediate medical attention.

Firstly, the presence of fresh red blood, especially if it is heavier than a normal menstrual period or accompanied by severe pain, could indicate retained products of conception or an infection. The fact that you experienced swelling in your face after taking medication suggests a possible allergic reaction, which should be taken seriously. If you have any signs of an allergic reaction, such as difficulty breathing, swelling of the lips or tongue, or hives, you should seek emergency medical care.

The abdominal pain you described as "cramping" can be a normal part of the recovery process, but if it becomes severe or persistent, it is essential to consult with a healthcare provider. The ultrasound performed by your doctor indicated that there was nothing concerning at that time, but if your symptoms worsen or do not improve, a follow-up examination may be necessary.
Regarding the medications prescribed, it is essential to follow your doctor's advice. If your doctor has indicated that it is okay not to take uterine contraction medication, it is likely because they believe your body can manage the recovery process on its own. However, if you feel uncertain or if your symptoms persist, it is always best to seek a second opinion or return to your healthcare provider for further evaluation.

As for massaging the uterus, this is generally not recommended unless advised by a healthcare professional. The uterus will naturally contract and expel any remaining tissue, and unnecessary manipulation could lead to complications or increased discomfort.

In summary, while some abdominal cramps and light bleeding can be normal after an abortion, you should be vigilant for any signs of complications, such as:
1. Heavy bleeding: If you soak through a pad in an hour or less for two consecutive hours, seek medical attention.

2. Severe abdominal pain: If the pain is intense and does not improve with over-the-counter pain relief, consult a doctor.

3. Fever: A fever over 100.4°F (38°C) could indicate an infection.

4. Foul-smelling discharge: This could also be a sign of infection.

If you experience any of these symptoms, it is crucial to seek medical attention promptly. Regular follow-up appointments with your healthcare provider are essential to ensure that your recovery is progressing well. If you have any doubts or concerns about your symptoms, do not hesitate to reach out to a healthcare professional for guidance. Your health and well-being are the top priority, and it is always better to err on the side of caution.

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