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Have had mirena and found pregnant. No sac seen on ultrasound. How to terminate pregnancy?

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General & Family Physician
Practicing since : 1978
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i have had mirena in for 4.5 years. i recently found out i was pregnant on monday of this week. i have had 2 hcg levels tested- second one doubled. they are watching me now, but im having dull pain on right side. doc thinks im about 4 wks. cannot see sac on ultrasound. would like to terminate pregnancy. what is the earliest i can do ? and what are risks? doctor has removed iud.
Posted Sat, 24 Nov 2012 in Abortion and Stillbirth
Answered by Dr. Pavan Kumar Gupta 2 hours later
Thanks for the query.
Although termination of pregnancy can be done upto 24 weeks but they are generally very safe if  done before 12 weeks of pregnancy and have a low complication rate.
The two most common methods employed are either by using abortion pill and the other is surgical removal of the fetus.
 The two most common complications are infection and failure to completely empty the womb. Both of these can cause prolonged heavy bleeding in the days following the procedure so if this occurs, medical advice should be sought. Infection is treated with antibiotics whereas incomplete removal of the womb contents requires a D&C under general anaesthetic to remove the remaining matter.
 Other complications include perforation of the womb with the suction instrument and trauma to the neck of the womb which may result in a condition called incompetent cervix which could lead to a risk of miscarriage in later pregnancies.
You must talk to your treating doctor and discuss about various methods and then decide accordingly.
I hope to have answered your query however you may revert to me for XXXXXXX further query.
Best of luck
Above answer was peer-reviewed by
Follow-up: Have had mirena and found pregnant. No sac seen on ultrasound. How to terminate pregnancy? 15 hours later
thank you. i am today spotting/ bleeding a little. would this be a miscarriage or can you spot with a pregnancy ? or eptopic?
Answered by Dr. Pavan Kumar Gupta 15 hours later
A number of things could be causing your light bleeding.
1... You may be experiencing breakthrough bleeding. This happens when pregnancy hormones cover up your usual menstrual cycle, but that cycle continues for a while. So, around the time you would have had a period if you weren't pregnant, you may get a little bleeding. You may have this bleeding more than once. 

2...Another cause of light bleeding is the fertilised egg implanting in your uterus (womb). Implantation bleeding is thought to occur at about the same time as your period would have been due. This makes it hard to tell implantation from breakthrough bleeding. 

3...Your bleeding may be caused by your cervix softening, forming a raw area. This is called cervical erosion or ectropion. This bleeding generally occurs during sex.

4..threatened miscarriage can also cause bleeding but is generally accompanied by cramping.

5.. In some cases,it becomes difficult to pinpoint the cause if bleeding is very minimal.

Just wait and watch and if you find that bleeding is getting heavy and with clots and with cramping,then you should consult your doctor for the evaluation and diagnosis.


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