Creator: Dr. Sameer Kumar
Published: 2017-06-22T16:00:43-04:00

Patient's Query

Hi doctor,

I had unprotected intercourse on the 11th. My menses date was on 26th of the same month, but I missed my menses. I had a pregnancy test after eight days and it was positive. I took the first set of abortion pills on the same day at 6:30 PM. At 10:30 PM, I started to have bleeding and the cramps and pain continued till morning 6 AM. It bled and five to six blood clots were there. I took my second set of pills at 10 AM. After that bleeding was very less, but the cramps were there. Till now I have some bleeding and small spots with an interval. Is everything working well? I want to assure that the abortion is complete. Please suggest me.

Answer

Dr. Sameer Kumar

Infertility Obstetrics And Gynaecology

Hello,

Welcome to icliniq.com.

Firstly, you have not mentioned the name of the pills or the pack that you have taken for medical abortion. From the set of pills, I understand that you have taken two pills at 6.30 PM and then a second set of Misoprostol pills at 10 AM after 16 hours. This is a wrong protocol to use just Misoprostol pills alone and also at such a gap of 16 hours.

The bleeding experienced may just be an endometrial shed and the gestational sac may not have been aborted out at all, because cytotrophoblastic invasion has not been stopped by the first pill called Mifepristone. As the bleeding has stopped it is suggested that you should get a transvaginal ultrasound done tomorrow or today to see if the sac has been aborted or not as you saw fewer blood clots and no tissue like glistening lump. I feel that you have not aborted yet as the pills have been wrongly consumed.

I want you to mention the name of the pack that you have used or the name of the pills that you have consumed. There are multiple packs available and the only concern in such early pregnancy of less than seven weeks is that Mifepristone is required 36 hours prior to Misoprostol intake and then completion success rates are higher. Nevertheless, get a transvaginal ultrasound done to check for completion and review with the report.

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Patient's Query

Thank you doctor,

The name of the kit is Termipil kit, combo pack of Mifepristone and Misoprostol and five tablets were there. I took three of them first and two tablets later. What is the color of gestational sac? When we can say that it has been removed? I do not have heavy bleeding, but spotting is still there. I had cramps and clots. I bled for the first eight hours of the first set. Is it fine? Please suggest me.

Answer

Dr. Sameer Kumar

Infertility Obstetrics And Gynaecology

Hello,

Welcome back to icliniq.com.

You have taken the pills in a wrong manner. Mifepristone is to be taken alone and then after 36 hours two pills of Misoprostol has to be taken and then after another four hours the remaining two pills of Misoprostol. The successful completeness cannot be guaranteed in your case as the sac does not seem to have passed, which are a fleshy, shiny and glistening good covered mass. If it passed, then one can say that medicines have worked.

Still, as you have expended the kit, please do not take more tablets now. Wait for the bleeding to stop and then do an ultrasound after 48 hours of stoppage of bleeding to confirm the completion. You may follow up with the reports or in case of excess bleeding.

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