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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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After Taking Mifepristone Pill The Bleeding Started After 28 Hrs. Is It Normal?

Hi, My wife is using MTP Kit to abort... After taking Mifepristone pill the bleeding started after 28 hrs. Is it normal. Also the doctor has suggested us post 48 hrs of taking Mifepristone we should take 4 tablets of Misoprostol every 6 hrs. However the chemist suggested that we should take 2 tablets of Misoprostol in the morning and 2 in the evening post 36 hrs of taking Mifepristone.

Please advice if we are going right.
Thu, 18 Apr 2013
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OBGYN 's  Response
Hello
Thanks for your query.

It is sad that medical abortion kits and medicines are freely available from chemists without a proper prescription, but it is illegal and unethical.
In addition, for the patient, it is highly dangerous , life threatening and risky.
I advise you not to take a single tablet without first consulting a Gynecologist.
I will try to explain why this is so.

Firstly, the pregnancy has to be confirmed by a gynecologist, not just by a home urine pregnancy kit, as home tests are not always reliable.
Then the exact weeks and days of the pregnancy have to be confirmed, because beyond 49 days of pregnancy, there is a high likelihood that the medical abortion pills will not work.
Thirdly, it has to be confirmed that the pregnancy is intra uterine, that is not outside the uterus. If it is an ectopic pregnancy ( pregnancy outside the uterus ), the results of taking such tablets randomly can be life threatening.
Fourth, the exact dosage and schedule has to be explained to you by a gynecologist, because even if you make a single mistake in taking the pills, the abortion would not be successful.
Fifth, after taking the pills, you need to have a follow up visit with your gynecologist, so that she can confirm that the abortion is complete, and the uterus is empty. Otherwise you have chances of incomplete abortion and the dead tissue being retained inside the uterus, leading to severe infection and other complications.
Sixth, anytime after taking the pills, you would have heavy bleeding and cramps with passage of tissues. In some patients the bleeding can be severe and you would require emergency hospital care, which is possible if you have already consulted a reputed gynecologist.

I hope I have given you enough reasons to understand the importance of consulting a Doctor before taking those pills.
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General & Family Physician Dr. Muhammad Ishfaq Habib's  Response
Hi
Welcome to HCM

The mifepristone is a prostaglandin F2 Alpha and is commonly used as anti inflammatory and as its effects on the uterus of causing forceful contraction, it is also used to induce medical abortion.

The abortion occurs only when there is endometrial along with the implanted zygote or in similar words you can say that the pregnancy is terminated when the menses occurs. So after taking mifepristone the bleeding is normal and it means that the pregnancy is terminated.

The pharmacist have told you the therapeutic dose which the doctor have told you the dose necessary to induce abortion. so, go with the doctor's opinion

Thanks
Regards
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After Taking Mifepristone Pill The Bleeding Started After 28 Hrs. Is It Normal?

Hello Thanks for your query. It is sad that medical abortion kits and medicines are freely available from chemists without a proper prescription, but it is illegal and unethical. In addition, for the patient, it is highly dangerous , life threatening and risky. I advise you not to take a single tablet without first consulting a Gynecologist. I will try to explain why this is so. Firstly, the pregnancy has to be confirmed by a gynecologist, not just by a home urine pregnancy kit, as home tests are not always reliable. Then the exact weeks and days of the pregnancy have to be confirmed, because beyond 49 days of pregnancy, there is a high likelihood that the medical abortion pills will not work. Thirdly, it has to be confirmed that the pregnancy is intra uterine, that is not outside the uterus. If it is an ectopic pregnancy ( pregnancy outside the uterus ), the results of taking such tablets randomly can be life threatening. Fourth, the exact dosage and schedule has to be explained to you by a gynecologist, because even if you make a single mistake in taking the pills, the abortion would not be successful. Fifth, after taking the pills, you need to have a follow up visit with your gynecologist, so that she can confirm that the abortion is complete, and the uterus is empty. Otherwise you have chances of incomplete abortion and the dead tissue being retained inside the uterus, leading to severe infection and other complications. Sixth, anytime after taking the pills, you would have heavy bleeding and cramps with passage of tissues. In some patients the bleeding can be severe and you would require emergency hospital care, which is possible if you have already consulted a reputed gynecologist. I hope I have given you enough reasons to understand the importance of consulting a Doctor before taking those pills.