Brief Answer:
rule out pregnancy by urine preg test first...

Detailed Answer:
hello,
Thanks for contacting healthcare magic.

Ideally after unwanted 72 , the bleeding should start within 7 days , but now as you have missed your periods beyond 3 days , it is better to rule out pregnancy by a urine pregnancy test . There could be chances of pill failure as its most effective the earlier it is taken , within 6 hrs.

so rule out pregnancy first.

regards,
dr XXXXXXX XXXXXXX

---

Brief Answer:
explained....

Detailed Answer:
hello,
thanks for the follow up.

yes you are right that it is to be taken within 72 hrs , but the efficacy is seen to be best when consumed within 6 hrs. as you have already crossed 14 days after the consumption of unwanted , the concern is that by now you should have had the bleeding, hence i said do a pregnancy test.
Ideally a pregnancy test should be done after 7 days of missed period but it you have taken a contraceptive pill but no bleeding , then you can go ahead and do the test as it would hcg produced in 2 weeks would be sufficient to give a positive test if at all. If you wish to wait for 3 more days , it should not change the outcome though and you may opt for it and decide to wait.
The pregnancy test kits are available off the counter and are cheap. you may do the one today and repeat another after 3 days to be doubly sure.
If its negative then you may wait for your periods to return naturally
regards,
dr XXXXXXX

---

Brief Answer:
explained...

Detailed Answer:
hello,
thanks for the follow up.

Now that your pregnancy test is positive and considering your last menstrual period which was on 9th NOV, you are at 4 weeks and 4 days. So , if you have decided not to continue with the pregnancy then you can opt for termination of pregnancy with medical methods , as it can be used till 49 days of pregnancy.

But before that you have to confirm by ultrasound whether the pregnancy is inside the uterus or inside the tubes, just to be on a safer side. After that you may start the following protocol:-
TAB MIFEPRISTONE 200mg stat, then
after 36 hours,
TAB MISOPOROSTOL 800 mg ( 4 tabs of 200mg) stat , followed by
tab misoprostol 400 mg ( 2tabs) 4hrly till maximum dosage of 2000mg of misoprostol.

you may experience excessive bleeding and pain due to uterine contractions as the uterus would try to expell the products. Once there is a sudden relief of pain and the contractions die down and you see products in the sanitary pad, it usually indicates completion of abortion, but that needs to be reconfirmed with an ultrasound transvaginally to ensure completion after another 48 hrs.
Your bleeding would reduce once the abortion is complete and spotting may last for a week.

Though it is always advisable to perform the same under supervision of your gynecologist as sometimes excessive bleeding may cause dizziness and weakness, so it is advisable to consult your nearest gynecologist for the abortion procedure.

I hope you understood my point.
regards,
dr XXXXXXX XXXXXXX

---

Brief Answer:
please read protol again...explained again

Detailed Answer:
hello,
thanks for the follow up.

Please read this protocol again ,
TAB MIFEPRISTONE 200mg stat, then
after 36 hours,
TAB MISOPOROSTOL 800 mg ( 4 tabs of 200mg) stat , followed by
tab misoprostol 400 mg ( 2tabs) 4hrly till maximum dosage of 2000mg of misoprostol.

This means that if you have taken at 3pm yesterday 12/12/2014 afternoon then you have to take tab misoprostol 800mg ( 4 tabs of 200mg each, not 100mg , if 100mg then 8 tabs together) all together on 14/12/2014 at 3 am in the early morning with 2 glasses of water.

The bleeding doesn't start with mifepristone , you have to take misoprostol tomorrow early morning and complete the course.
however keep yourself well hydrated.

regards,
dr XXXXXXX

---

Brief Answer:
hello

Detailed Answer:
hi ,
did you take the second and third dose of misoprostol as well or just took 800mg .
i f the pain is still there then the products are still there. you should complete the protocol course.

This light bleeding can continue till 7 days , but after completing the course , you may get an transvaginal ultrasound after 48 hrs to look for complete abortion and confirmation.

regards,
dr XXXXXXX

---

Brief Answer:
good to hear that..but no gym yet...explained

Detailed Answer:
hello,
good to hear that you are fine now.

But you have to get an ultrasound transvaginally to check for endometrial thickness and to rule out any remaining products of conception to confirm the completion.

Secondly regarding the gym , you may postpone it by 2 weeks, as the uterus has just aborted and shall take atleast 2 weeks for returning to the pre -pregnant state. Also the hormone levels would also take atleast 2 weeks to stabilize to prepregnant levels. Heavy exercise may cause involution of uterus and you may start bleeding again.
it is advisable to take warm drinks and beverages for 2 weeks to help early involution.
SCAN is a must as it would allow me to know that you are completely fine now, as well.

wishing you good health. Also please follow contraceptive practices and dont get pregnant for atleast next 4 months.

regards,
Dr.Sameer Kumar

You may close the query if no further questions.

---