HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

What Is The Cause Of Bleeding For 3 Weeks After The Termination Of Pregnancy?

Posted on Thu, 6 Mar 2014

Question: Hi, I had gone ahead with medical termination of 7 weeks pregnancy on XXXXXXX 8th. The bleeding didn't stop after 3 weeks. The doctor advised me to wait for a week and after 4 weeks repeated misoprost. I did pass some small clots after that. The repeated ultra sound scan shows as follows: UT : 9.1x5.4x5.6 vol 145 ml ET : 13 mm RPOC : 1.5x1.7x1.7 vol 2.3 ml C blood flow Right ovary 4.4x3.5x4.2 vol 34 ml RO shows 2 cysts the largest 3 cms Left ovary : 2.0x 2.0x 1.5 vol 3.3 ml Impression RPOC Pl. suggest what should be the next course of action for me. Thanks, Shalini

Answered by Dr. Dattaprasad (26 minutes later)

Brief Answer: Two options: Repeat misoprostol/D & C. Detailed Answer: Hi XXXXXXX Welcome to HCM. There are two options to get rid of RPOC. One is to repeat misoprost (No harm is done by repeating it) OR other option is to go for curettage of uterus (Called as D & C). D & C is a minor surgery done in operation theater & might require anesthesia, while repeating misoprostol doesn't require anesthesia. If RPOC remain even after repeating misoprostol, again you may need D & C. To avoid that you can go straightforward for D & C. Let me know whatever option you select. You can ask if you have any other queries. Regards.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Dattaprasad (28 hours later)

Hello Doctor, As suggested I have gone ahead with repeat dose of misoprost as of now. I would like to know that what are the chances that I do not have to go ahead with the D & C. Is there any food etc I can take to enhance the medicine effect ? Thanks, Shalini

Answered by Dr. Dattaprasad (50 minutes later)

Brief Answer: Good chance of abortion if bleeding starts. Detailed Answer: Hi XXXXXXX Welcome back. There is good chance of abortion completing with medicines only ( not requiring D & C) if bleeding starts. Medical abortion has efficacy of 95% before 7 weeks. But if bleeding doesn't start at all, you will require to get scan done to confirm that pregnancy is in uterus & not elsewhere. Regarding food, papaya is said to contain high levels of prostaglandins & assist in abortion, but it is not scientifically proven. Kindly wait for 48 hours. If bleeding starts & flow is low, you can repeat misoprostol once more (may be at higher dose if needed) to complete abortion. Hope this helps you. Regards.

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

Follow up: Dr. Dattaprasad (28 hours later)

Hello Doctor, The bleeding has started and I am passing small blood clots. So I hope things work out well. I have caught cold since today evening. I am sneezing and have a bad head-ache. It looks like I might get fever in a day or so. What should I do in this case ? Thanks, Shalini

Answered by Dr. Dattaprasad (15 minutes later)

Brief Answer: Can take OTC cold medicines. Detailed Answer: Hi, You can take over the counter cold medicines like cetrizine. In case of fever/hedache you can take paracetamol tablets. Once bleeding starts, abortion should complete in 48-72 hours. You can check for its completeness by one scan after bleeding stops. Regards.

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

Follow up: Dr. Dattaprasad (38 hours later)

Hello Doctor, Thanks for replying patiently. I did a repeat of misoprost 200 yesterday and went for a scan today. The scan still shows RPOC 1.11x1.0x.9 vol 1 ml Till now I have had misoprost thrice 1. Once in the start 2. Bled for nearly 4 weeks 3. misoprost 200 on sunday 4. misoprost repeated on thursday (yesterday) I am bleeding till now. What are the chances that the clot will be released in sometime. How much time does it takes for the clot to release ? Do I need to take misoprost again with higher dosage ? or go ahead with D n C ? Thanks, Shalini

Answered by Dr. Dattaprasad (2 hours later)

Brief Answer: Abortion should be complete. Detailed Answer: Hi XXXXXXX Blood clot/RPOC of 1mL is not very significant & as you said that you are bleeding till now, it should get evacuated. With the progress in bleeding & reduction of RPOC volume, you should not require either repeat misoprostol or D & C. Let the bleeding stop & then repeat scan. Minor amount of RPOC (Thickness<0.8-1cm) should come out with your next menses. If RPOC has no blood flow (your initial scan had RPOC of 2-3mL with blood flow), there should not be any reason for worry. It can take around 3-7 days for clot to get released after bleeding starts. In the rare instance of RPOC not getting cleared (chance of which is very low), its better to go ahead with D & C as you already taken misoprostol multiple times. Regards.

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