How to terminate pregnancy?

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Posted on Thu, 11 Jun 2015 in Pregnancy
Question: My wife is 4.3 weeks pregnant, tested by preganews strip. we visited a gynologist, as per her we should not abort this it may cause problem in future for pregnancy. There was no test done.
As we want to abort, she(gynologist) prescribed mifegest kit.
My wife is 5feet 2 inch and body weight is 52 kilo
Our questions are,
1. Can this abortion cause any problem in future pregnancy? As we want take baby after 2 years. This is very important for us to have baby in future.
2. Is mifegest kit totally successful for abortion?
3. My wife did not take mifegest kit yet. But now she is having bit water loss today.

Please suggest ... Thanks in advance.
doctor
Answered by Dr. Srilatha Myaka 56 minutes later
Brief Answer:
medical method is safest

Detailed Answer:
Hello dear,welcome to healthcare magic.I understand your concern.
In my opinion the answer to your first question is medical method is the safest of all methods of abortion.
Medical methods is termination of pregnancy by oral medicines.And it can be done within 6 weeks.
Surgical methods is termination of pregnancy by procedures like D&C,suction etc.It is done between 6 to20 weeks of pregnancy.
Medical methods is safest of all because the uterine environment is not disturbed.
Whereas in surgical methods the internal milieu might be disturbed due to scarring sometimes.
So mifegest might be safe but cannot say it to be 100% .It might be safe upto 80- 90%.As it is hormone there might be some hormonal abnormalities leading to alteration of few cycles later.
The answer to your second query is I need to know what do you mean by loss of fluid?
Is it loss of fluid per vaginum or anything else?
Kindly provide me the information.
Looking forward to hear from you.
Best regards..Dr srilatha
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Srilatha Myaka 17 minutes later
Fluid lose from vgina. But its not much. May be it cause d from tension.

1. Should she do USG of lower abdomen before taking mifegest kit?
2. What is the proper way to take mifegest kit?
3. So per you there is no future pregnancy risk?
4. If mifegest kit fails to do its job, then do we need surgery? In that situation is surgery safe?
5. We have consulted with two Dr. Both said. We should not abort. Is this process to tell couple not to abort.?
doctor
Answered by Dr. Srilatha Myaka 47 minutes later
Brief Answer:
surgical method is preferred when medical method fails

Detailed Answer:

Hello sir,thanks for the information.I understand your concern.
In my opinion the fluid leak from vagina might be vaginal discharge.It might not be worrisome.
The answers for your query are:-
1)Yes ultrasound need to be done before the process to confirm if the pregnancy is within uterus or outside the uterus.Because the outside uterus ie.,ectopic pregnancy might not respond to abortion pills.
2)Mifegest kit usage-Tab.mifepristone 200 mg might be taken and after 48 hours of gap the 4 misoprostol tablets might be taken.Bleeding usually starts after this.
3)It might be safe as it avoids complications of surgery.Not 100% safe.Risk for future pregnancy might be upto 10- 20%.
4)If mifegest fails you have to go for surgical procedures.But failure of mifegest might be seen in 1 to 2 %.It works well with early pregnancy.
5)Even then the complications of surgical procedure might be there.They might not be seen in all cases.
6)Any doctor dont favour termination for fear of unpredictable future.Every doctor gives counselling for pregnancy continuation only.
But if it is definite , option need to be taken by accepting the risks.Its not that complications are sure they might happen in certain percentage of cases.
Hope this satisfies your query.
Feel free to discuss further.
Best regards..Dr.srilatha
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Srilatha Myaka 32 hours later
First of thank you very much. Your help is very much appreciated.

We few more questions as follows.

1. "Mifegest kit usage-Tab.mifepristone 200 mg might be taken and after 48 hours of gap the 4 misoprostol tablets might be taken.Bleeding usually starts after this."
She have to take 4 misoprostol after 48 hours of gap that is OK. But should she take 4 misoprostol together or does it need any time gap?
Mifepristone She have to eat. Not misoprostol should she eat or need to insert through vagina? Which process is more safe and effective?
After how hours of take take mifepristone she should expect bleeding?

2. Is there any strict instruction that mifepristone have take at morning? Should she take it empty stomach?
Is there any special diet she need at that time? Or which food she should not take?

3. Yesterday she had blood grouping and himoglobin test. Group is AB+ and himoglobin is 10
Himoglobin is a bit. So should she take any medicine, reason she is going to loss lots of blood?

4. Yesterday she also had a lower abdomen ultrasound test. At that time Dr. cant see any thing about pregnancy, because it is less than 1 month or may e 15 to 20 days. Today we will get the report. And will visit our gynologist at evening. Then she will take mefigest.
All I want to, am I missing anything?

5. Is there any medicine she should take after medical abortion?
doctor
Answered by Dr. Srilatha Myaka 2 hours later
Brief Answer:
timing of bleeding might vary

Detailed Answer:
Hello sir,I got your query.I understand your concern.
In my opinion the answers for your queries are:-

1)Tab. misoprostol 4 tablets should be taken one after one with no time gap.

2)Tab.misoprostol can be taken orally or inserted vaginally.But vaginal insertion might require hospital admission. Both the routes of administration are effective.

3)There is no need of particular timing or any relation to food with regarding to mifepristone.
But you should take both medicines on same time.For example if you take mifepristone at 11 am today ie. 8 th then take misoprostol on 11 am on 10th.

It is important that you discuss about the described schedule with her gynecologist before acting on it.

4) The bleeding might start usually 6 to 10 hours after misoprostol intake.But the period might vary highly.

5) As the Hb is 10 and there will be heavy loss of blood, she needs to take iron tablet daily after abortion for 1 month.

6) Yes, early pregnancy can't be seen in ultrasound.

7) You are not missing anything.But get ultrasound done after 2 weeks to know if abortion is complete.

Hope this satisfies your query.
Feel free to discuss further.

Best regards

Dr.srilatha
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Srilatha Myaka 10 days later
Hello,
My wife used mefigest kit on Saturday. 1 mifepristone on 8 am 9th may. And 2 misoprostol on 8 am and other 2 misoprostol on 8 pm 11th may.
Bleeding started after 3 hours of taking first misoprostol. Heavy bleeding continued till 16th may.
From 17th bleeding came down a bit.
Today 18th may she was able to go to work. After returning from work, she started bleeding heavily again?

Is it normal? Or it may be cause from some thing?
What should I do?
doctor
Answered by Dr. Srilatha Myaka 1 hour later
Brief Answer:
it might be normal but needs to be evaluated

Detailed Answer:
Hello dear,welcome to healthcare magic.I understand your concern.Iam glad to answer you again.

In my opinion the bleeding till 2 weeks ie., 24 th may might be normal. But as the bleeding is heavy it might be better to consult your doctor. If her general condition is stable and there are no symptoms like giddiness then you might not worry. But doctor consultation would be good to check her BP and Hb status.

Bleeding even after 24 th may might be abnormal and might suggest incomplete abortion.Whatever the case may be i suggest you to get an ultrasound done after 24 th may to confirm the abortion is complete.

Dont worry.
Hope this satisfies your query.
Feel free to discuss further.
Best regards...dr.srilatha
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Srilatha Myaka 39 hours later
Thank you ..

She is still bleeding. And paining in lower abdomen and both legs. Got fever. Temperature near about 100. She got conjunctivitis in her eye yesterday (may she got infection from school.

She told me to tell you about her condition. Plz suggest.
doctor
Answered by Dr. Srilatha Myaka 2 hours later
Brief Answer:
Infection should be ruled out

Detailed Answer:
Hello dear,Welcome to healthcare magic.I understand your concern.In my opinion it is better to rule out infection in case of fever with pain abdomen.So I suggest you to consult doctor and get investigations done like complete blood counts to rule out infection.Check for any foul smelling vaginal discharge because it might be sometimes associated with infection.Meanwhile take tab.panadol 500mg for fever.
Pain in legs might be due to weakness caused by loss of blood.
If there is any infection you might need a course of antiboitics.Nothing to worry.
Take healthy nutritional diet and iron rich food along with iron supplements.
Conjunctivitis might need antiboitic drops.As there is blood loss the immunity will be lower predisposing to infections.
Once her general condition improves she will become normal.
Hope this satisfies your query.
Feel free to discuss further.
Best regards....dr.srilatha
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Srilatha Myaka 44 hours later
She is still bleeding. She is feeling very week. Can she take dexorange tablets for himoglobin?
doctor
Answered by Dr. Srilatha Myaka 1 hour later
Brief Answer:
Weakness might be due to bleeding

Detailed Answer:
Hello dear,welcome to healthcare magic.I understand your concern.
In my opinion dexorange tablets can be taken to increase the HB.The weakness might be due to bleeding.It is routinely seen in cases of bleeding.Dont worry.
The tablet is to be taken at night one hour after food.Because rice hampers the iron absorption.
Take iron rich food like green leafy veggies,beet root,dates,zaggery and liver.
Take dexorange tablets for a month.The dose once or twice can be decided basing on HB report.
Check for the bleeding and any retained products of conception can be seen in ultrasound.
Hope this satisfies your query.
Feel free to discuss further.
Best regards...Dr.srilatha
Above answer was peer-reviewed by : Dr. Shanthi.E
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Dr. Srilatha Myaka

OBGYN

Practicing since :2007

Answered : 2422 Questions

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