Post-Medication Abortion: Blood Clots and Future Pregnancy Concerns

After a medical abortion, is it normal to have small blood clots, and could they have any impact?

Hello, after a medical abortion, I took the medication twice and returned for a follow-up appointment a week later.
The doctor performed an ultrasound and said that everything was cleared out, but there were still some blood clots, and a cyst was found.
They prescribed a milder uterine contraction medication for me to take (after meals and before bed for three days), and mentioned that the cyst would resolve on its own, so there was no need for a follow-up visit.
After taking the medication, I didn't pass any significant blood clots; the discharge was brownish like at the end of a menstrual cycle, but very minimal...
almost none.
I would like to ask: 1.
After taking this medication, how can I be sure that the blood clots have been fully expelled? 2.
If the blood clots have not been expelled, (1) will it have any effects? (2) Will it affect future pregnancies? 3.
What impact can the cyst have? Will it really disappear? Why did it suddenly appear? Thank you.

Jane, 20~29 year old female. Ask Date: 2016/01/11

Dr. Lin Wenbin reply Obstetrics and Gynecology

1.
You need to consult the original physician for an ultrasound examination to confirm the findings.

2.
If the pregnancy tissue is not completely expelled, it may affect future pregnancies.

3.
Did the original physician explain the cause of the blood clots? It would be better to first consult the original physician about the examination results for clarity.

Reply Date: 2016/01/11

More Info

After a medical abortion, it is common to have concerns regarding the expulsion of blood clots, the presence of any remaining tissue, and the implications for future pregnancies. Let's address your questions one by one.

1. How to confirm that blood clots have been expelled?
After taking medication for abortion, follow-up care is crucial. Typically, a healthcare provider will perform an ultrasound to check for any remaining tissue in the uterus. If your doctor has indicated that the uterus is "clean" but you still have some blood clots, it is essential to monitor your symptoms. If you experience heavy bleeding, severe pain, or any signs of infection (such as fever or foul-smelling discharge), you should contact your healthcare provider immediately. In many cases, light bleeding or spotting can continue for a few weeks post-abortion, which is normal.
2. If blood clots remain, what are the implications?
(1) Impact of remaining blood clots: If blood clots or tissue remain in the uterus, it can lead to complications such as infection or prolonged bleeding. In some cases, this may require further medical intervention, such as a dilation and curettage (D&C) procedure to remove any retained products of conception.
(2) Effect on future pregnancies: Generally, if the uterus is cleared of any remaining tissue and there are no complications, having retained blood clots should not significantly impact future pregnancies. However, if there are complications like infection or significant scarring of the uterine lining (Asherman’s syndrome), it could affect fertility or the ability to carry a pregnancy to term. Regular follow-up with your healthcare provider is essential to ensure that your reproductive health is maintained.

3. What about the water bubble?
The "water bubble" you mentioned could refer to a fluid-filled structure, such as a cyst or a retained gestational sac. In many cases, these structures can resolve on their own without intervention. Your healthcare provider likely determined that it was not a cause for concern, but it is essential to monitor any changes. If the bubble does not resolve or if you experience any symptoms such as pain or abnormal bleeding, you should follow up with your doctor.
In summary, after a medical abortion, it is crucial to have follow-up appointments to ensure that the uterus is clear of any remaining tissue and to monitor your overall health. If you have any concerns about your recovery or future pregnancies, do not hesitate to discuss them with your healthcare provider. They can provide personalized advice based on your medical history and current health status.
Additionally, it is important to maintain a healthy lifestyle and consider prenatal vitamins, especially folic acid, when planning for future pregnancies. This can help support a healthy pregnancy when you decide to conceive again. Always consult with your healthcare provider for tailored advice and recommendations.

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