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Suggest Remedy For Vomiting After Mifepristone Intake

Posted on Wed, 2 Dec 2015

Question: Hello my wife took first tablet of mifepristone yesterday and today she took 4 Tablets of misprotol after 24hrs. She kept the 4 tablets in her mouth for 30mins but after she swallowed them, within two minutes she vomitted. We had done the ultrasound before and it was not an ectopic pregnancy and it is a normal pregnancy. However today its her 9th week 1day of her pregnancy. May I know what should I do or do I need to be worried since she has had vomit. We live in a country where abortions are illegal MTP was our only option therefore. Please advise.
Thanks.

Answered by Dr. Deepti Verma (30 minutes later)

Brief Answer:
Vaginal misoprostol

Detailed Answer:
Hi dear, I have gone through your question and understand your concerns.
If she has vomited out misoprostol, then the tablets are ineffective.
To complete the process of abortion, she should take the four tablets of misoprostol vaginally.
It is effective than oral route, and there is no risk of vomiting.
Hope you found the answer helpful.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepti Verma (6 minutes later)

she has already started bleeding. The concern regarding vaginal insertion is if we need hospitalization they would be able to detect it and it could land us in big trouble legally. Can she take the next 4 Tablets orally after 3hrs? since irs already 2hrs she had her first tablet. And how intense bleeding will be? what should be a warning level in bleeding intensity?

Answered by Dr. Deepti Verma (1 hour later)

Brief Answer:
Misoprostol orally after ondansetron

Detailed Answer:
Hi dear,
She can take misoprostol orally after taking an anti emetic tablet (ondansetron).
It will prevent the vomiting due to misoprostol.
Bleeding will be slightly more than the normal periods.
If the bleeding is more, soaking more than 2 pads in 2 hours, then she should consult an OBGYN specialist immediately.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepti Verma (19 minutes later)

She has bled two big clots which looks like soft jelly. I am attaching images please have a look and advise if she needs to take the second dose of Misprostol. also please advice us if the bleeding is abnormal or not? As per my belief since she is excreting clots may be thats why she is bleeding more. But your professional opinion would matter most

Answered by Dr. Deepti Verma (17 minutes later)

Brief Answer:
Process of abortion almost complete

Detailed Answer:
Hi dear,
I have reviewed the photographs.
They show that the fetus and the products of conception have expelled and the abortion is almost complete.
The second dose of misoprostol will facilitate expulsion of any remaining products of conception, and is recommended in low dose (2 tablets of 200mcg each).
The bleeding will decrease in quantity once the abortion is complete.
Hope you found the answer helpful.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepti Verma (4 hours later)

Hello Dr. my wife has passed the fetus. it was a fully formed fetus and wasnt damaged at all. Sorry I couldn't take a picture as it needed a courage which I simply didn't have. When she passed it she bled very heavily and was feeling alot of weakness just before passing the fetus. its been two and a half hours since she passed it and the bleeding has slowed down considerably since then and she isnt feeling any weaknesses anymore just a little pain which shes sayin is very mild. Just a last advice from you would be much appreciated. What things are to be looked out for in post abortion period. Also please advice me if she can take amoxcilin to prevent any infection development in the uterus. And what food she must take to compensate for the blood loss. Looking forward to have your comprehensive advice and once again thank u very much for very professional advices. Only if abortion wasnt illegal here I would have never taken such a grave risk with my wife's health. Abortion matters should have been a personal choice rather than a choice of the state..

Answered by Dr. Deepti Verma (8 hours later)

Brief Answer:
High protein and iron rich diet

Detailed Answer:
Hi dear, I have gone through your question and understand your concerns.
She should get a ultrasound done after15 days to check whether the abortion is complete or not. She should not get any heavy bleeding or pain in abdomen now
You should avoid conception for next6 weeks.
She can take amoxicillin to avoid infection.
She should take high protein diet, and iron rich food like dates, jaggery, sprouts, meat, to cover up the blood loss.
Hope you found the answer helpful.
You can get back to me anytime for further queries later by asking a direct question to me by asking a direct question to me on the health care magic portal.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Sonia Raina