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Is there any reliable way to know whether a medical abortion is unsuccessful?

Mar 2013
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Practicing since : 1998
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Hello, I had a medical abortion and experienced cramps, heavy bleeding, passing blood clots, etc. I did not see any tissue pass and I'm anxious to know if the treatment was a success and my follow-up appointment is not for 7 days. Any way to know when a medical abortion is unsuccessful? Any signs I should be looking for? Should I have seen tissue vs just blood and blood clots? Thank you.
Posted Tue, 31 Dec 2013 in Women's Health
Answered by Dr. Aarti Abraham 12 minutes later
Brief Answer: EXPLAINED BELOW Detailed Answer: Hello Thanks for writing to us with your health concern. See , basically the ONLY reliable way to tell if a medical abortion is successful - is to have an ultrasound scan after 15 days that will show an empty uterine cavity. Other than that, all other signs and symptoms are just suggestive. If it was a very early pregnancy ( 4 - 5 weeks ) then passage of tissue is not mandatory. Passage of heavy blood clots, bleeding with cramps for a few days - this is all you might experience in early pregnancy abortion. In advanced pregnancies, generally there is passage of a greyish white fleshy piece of tissue, alongwith the blood clots. This might go unnoticed, as you use the washroom sometimes, or it is deeply embedded inside the blood clot, you would not actually dissect out each and every clot , right ? So going by your description of having experienced heavy bleeding with cramps, I would say that the medical abortion worked for you. If right now you are having no heavy bleeding / severe pain / fever / foul smelling discharge, that in itself also is highly suggestive that the abortion is complete, and there are no residual tissues inside. Of course, you would know for sure only when you have your follow up exam and ultrasound scan. All the best. Please feel free to ask for further clarifications.
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Follow-up: Is there any reliable way to know whether a medical abortion is unsuccessful? 37 minutes later
Thank you for your reply and expertise. According to the ultrasound, I was measuring 6 weeks just before starting the process of the medical abortion. Is it common at 6 weeks to not see tissue pass? I'm still experiencing bleeding (though not super heavy) and have cramps but no severe pain, fever or foul smelling discharge. I took the miso pills less than 24 hours ago (at 4pm 12/10). Finally, what is the typical timeframe in which hCG levels return to normal and a pregnancy would not be detected via home pregnancy test and via blood sample? I have blood work scheduled for XXXXXXX 8th (unrelated to the medical abortion on 12/10)) and I'm curious the chances of the pregnancy showing up in that blood test. Thank you again!
Answered by Dr. Aarti Abraham 20 minutes later
Brief Answer: DETAILED BELOW Detailed Answer: Thank you for the appreciation. At 6 weeks, generally you would see a smallish piece of tissue, around say 2 by 3 cms. Bleeding is common for upto a few days after the pill intake, so do not worry. The urine and blood HCG tests would normalize generally in 3 - 4 weeks, but can show up for upto 60 days, so do not worry about that. Take care.
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