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How To Terminate Pregnancy?

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Posted on Mon, 30 Mar 2015
Question: Hi doctor, I am 4-5 weeks pregnant. After conforming the pregnancy through prega news, I have advised to take unwanted kit of mankind.
But as prescribed I have to take the Mifepristone first but wrongly I have started with the misoprostol first, in place of Mifepristone. I have taken 3 of them at 12 hour interval. Bleeding is there but it is not too much, now the bleeding is also stopped.
Please let me know do I have to again repeat the course of the same medicine again.
doctor
Answered by Dr. Sameer Kumar (33 minutes later)
Brief Answer:
you might have to repeat the kit again....you may not abort..explained

Detailed Answer:
Hello,
Thanks for the query to healthcare magic,
As you mentioned that you are 5 weeks pregnant and desirous of aborting the pregnancy. Now you have taken 3 misoprostol pills of 200microgram each at interval of 12 hrs, now this may or may not initiate a abortion as misoprostol wouldn't stop growth of placenta or the cytotrophoblasts into the endometrium, which is caused by mifepristone. All it does is to cause uterine contractions so that your body passes the uterine contents.
Now the bleeding you experienced was likely to be due to incomplete separation of placenta from endometrium which recovered later and then the bleeding stopped once the placenta kept growing further.
So it is suggested that you stop the pack now, and get 2 things done tomorrow:-
1. A transvaginal ultrasound to check for foetal heart beat or the gestational sac inside the uterus which shall confirm non expulsion of pregnancy.
2. Get a serum beta hcg test done for checking the level tomorrow.
Following this , repeat the beta hcg after 48 hrs again. If there is a rise of hcg values by more than 66% , then the pregnancy is still growing and viable. In that case you would have to repeat the pack again.

If the hcg levels are declining then it indicates that pregnancy has stopped growing and abortion shall ensue. In that case you may initiate abortion after 5 days with a stat dose of tab misoprostol 800 micrograms( 4 tabs of 200 microgram each).

I hope i have been able to address your concern in detail,
However it is suggested that you meet your physician for an ultrasound and beta hcg tests, discuss the options with them and then take a supervised and infomed decision.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sameer Kumar (2 hours later)
Hello Doctor,
Thanks for the answer. I have a query for now, can't we go for a prega news test rather than the beta hcg test.
Plz answer.
doctor
Answered by Dr. Sameer Kumar (3 hours later)
Brief Answer:
NO preganews, only serum beta hcg for quantification

Detailed Answer:
Hello,
Thanks for the follow up.

Prague news test is not advisable as it i a urine based test which can detect hcg but cannot quantify hcg levels , which can only be done by this blood based serum beta hcg test.
WE need to check for values of hcg 48hrs apart which can give us an idea about the present viability or non viable status of the foetus as explained earlier. So its not preganews , but a serum beta hcg test which needs o be done.
regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sameer Kumar

OB and GYN Specialist

Practicing since :2002

Answered : 1782 Questions

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How To Terminate Pregnancy?

Brief Answer: you might have to repeat the kit again....you may not abort..explained Detailed Answer: Hello, Thanks for the query to healthcare magic, As you mentioned that you are 5 weeks pregnant and desirous of aborting the pregnancy. Now you have taken 3 misoprostol pills of 200microgram each at interval of 12 hrs, now this may or may not initiate a abortion as misoprostol wouldn't stop growth of placenta or the cytotrophoblasts into the endometrium, which is caused by mifepristone. All it does is to cause uterine contractions so that your body passes the uterine contents. Now the bleeding you experienced was likely to be due to incomplete separation of placenta from endometrium which recovered later and then the bleeding stopped once the placenta kept growing further. So it is suggested that you stop the pack now, and get 2 things done tomorrow:- 1. A transvaginal ultrasound to check for foetal heart beat or the gestational sac inside the uterus which shall confirm non expulsion of pregnancy. 2. Get a serum beta hcg test done for checking the level tomorrow. Following this , repeat the beta hcg after 48 hrs again. If there is a rise of hcg values by more than 66% , then the pregnancy is still growing and viable. In that case you would have to repeat the pack again. If the hcg levels are declining then it indicates that pregnancy has stopped growing and abortion shall ensue. In that case you may initiate abortion after 5 days with a stat dose of tab misoprostol 800 micrograms( 4 tabs of 200 microgram each). I hope i have been able to address your concern in detail, However it is suggested that you meet your physician for an ultrasound and beta hcg tests, discuss the options with them and then take a supervised and infomed decision. Regards