Can a female have no bleeding despite taking Misoprostol 200 for abortion?

Question

Hi doctor,

I was eight weeks pregnant, and the baby had no heartbeat and was not growing. So the doctor said to avoid it, then gave Mifty kit. After taking the Mifty kit, I went for an ultrasound after eight days, but some sac parts remained after that doctor gave Misoprostol 200, six tablets to take twice daily. So I have taken two tablets yesterday night and today morning, but I have no bleeding.

Please help me.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

You have taken tablets, but they might be a bit lower dose or with a large duration difference. If it were given more frequently within less time period, it would be more effective.

Every woman's body responds to hormones a bit differently from others. Some women may not need even a single tablet and would start bleeding without medications. Few women, instead of getting high-dose medications not respond and end in the need for dilatation and evacuation. You discuss it with your doctor after a couple of days.

Are there any symptoms of pain?

Is there any bleeding you observe?

There could be another high-dose course of tablet Cytotec (either 100 mcg or 200 micrograms of Misoprostol, a synthetic prostaglandin E1 analog) or evacuation with or without support. Cytotec is used for cervical ripening dilatation to make evacuation easy.

It is the patient's choice as well if she wants to wait for everything to be done by nature or by medicine or removal with surgery. But risk factors or the possibility of heavy bleeding and abdominal pain are there as well. In case of bleeding or pain or dizziness, immediately report to the hospital.

Otherwise, wait for a couple of days for hormonal response locally and discuss with your doctor regarding medical (another course of Cytotec) and surgical (evacuation) as per your condition, examination, convenience, and need.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

I told you it is up to you. You can ask for evacuation, but as you previously had one cesarean section already, it is better that the bleeding starts itself and gradually remove and cleans the uterus.

If you opt for evacuation, it is better to have expert hands.

Start folic acid 0.4 milligrams daily.

Eat a healthy diet with daily walks and exercise with a normal basal metabolic index.
After evacuation or complete miscarriage better have two periods and prepare yourself for conception mentally, physically, and emotionally.
Try to have full treatment if any health issues you have.
Quit recreational drugs, both you and your husband, as these reduce fertility and increase the chances of anomalies. Have recreational activities.
Do yoga, exercise, and have a balanced BMI (basal metabolic index), neither low nor high.

Thank you.

Answer 3

Hi,

Welcome back to icliniq.com.

It would be really helpful if you would describe your medical, surgical, obstetrics, and gynecology history in detail.

There would be some reason for a vertical incision in the first baby.

Have you had any other chronic disease history or surgeries before the delivery of the child?

It depends on how your pregnancy goes and how much risk for normal and surgery could be taken for the baby and yourself.

You can discuss a less complicated way of delivery with your obstetrician.

Pay attention to yourself, as I described above, and think positively.

Thank you.

Answer 4

Hi,

Welcome back to icliniq.com.

Both can opt it depends on you and your baby's condition in the pregnancy and on the consultant what she might find easy, convenient, and best for you.

Lowline horizontal incision is given in normal patients but in some conditions in complicated patients. Even in patients with only one cesarean section, vaginal birth after cesarean can be an option but should be considered under the same expertise, opinion, and continuous care. You can have cesarean as an easy mode, and again vertical is also easy to deal with rather than a lower segment.

Thank you.