Incomplete Medical Abortion: Risks and Next Steps

Incomplete medical abortion, followed by suction aspiration, and then an ultrasound shows an increase in size?

Is there a possibility of this happening? After a medical abortion that was incomplete, the doctor performed suction and prescribed medication for three days, but upon follow-up ultrasound, it was found that there is still remaining tissue.
Is this possible? What should be the next steps in this situation?

Lan Tu, 20~29 year old female. Ask Date: 2015/12/05

Dr. Lin Wenbin reply Obstetrics and Gynecology

1.
Of course there is.
2.
Next, the physician who is following up should handle it.

Reply Date: 2015/12/05

More Info

Incomplete medical abortion, or medical abortion that does not fully expel the pregnancy tissue, can occur in a small percentage of cases. The likelihood of this happening can vary based on several factors, including the method used, the timing of the procedure, and individual patient factors. Generally, the risk of incomplete abortion after a medical abortion is estimated to be around 2-5%.
When a medical abortion is performed, it typically involves taking two medications: mifepristone and misoprostol. Mifepristone is taken first to block the hormone progesterone, which is necessary for the pregnancy to continue. After a period of time, misoprostol is taken to induce contractions and help expel the pregnancy tissue. In some cases, not all of the tissue is expelled, leading to what is termed an incomplete abortion.

If a follow-up ultrasound shows that there is still remaining tissue after a medical abortion, it is important to consult with a healthcare provider to discuss the next steps. The presence of retained tissue can lead to complications such as infection, heavy bleeding, or prolonged symptoms of pregnancy.
In cases of incomplete abortion, the following options may be considered:
1. Expectant Management: This involves monitoring the situation to see if the body will expel the remaining tissue naturally over time. This approach may be suitable for some women, especially if they are not experiencing significant symptoms.

2. Medical Management: If there is a significant amount of retained tissue or if the patient is experiencing symptoms, a healthcare provider may prescribe additional medication to help expel the remaining tissue.

3. Surgical Intervention: In some cases, a surgical procedure known as dilation and curettage (D&C) may be necessary to remove any remaining tissue from the uterus. This is typically done if there is a concern about infection or if the patient is experiencing heavy bleeding.

It is crucial to follow up with your healthcare provider after a medical abortion, especially if there are any concerns about incomplete abortion. They will be able to provide personalized advice based on your specific situation and health status.

In summary, while the risk of incomplete abortion exists, it is manageable with appropriate medical care. If you find yourself in this situation, it is essential to communicate openly with your healthcare provider about your symptoms and concerns, and to follow their recommendations for further evaluation and treatment.

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