What can be the reason to get clots after taking MTP pills?

Question

Hello doctor,

I had recently used MTP pills, and it is day 4. Day one, I took one tablet of 200 mcg; on the second day, I took 2 tablets, each 200 mcg. I did not take the two pills due to heavy bleeding. Also, I had a lot of clotting, though it must be cleared now. On the fourth day, I did ultrasonography and found that a few clots were still present. What is the best solution now? Will it clear automatically after a few weeks, or should I take the rest of the two pills now? Please help. Also, on day 4, the doctor suggested that I need to go for dilatation and curettage. I need your suggestion. Should I do it immediately? I am not in a position to do it now. Can I do a dilatation and curettage after some time, around two months? Please suggest. I have attached my laboratory tests for your reference. Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Considering the USG (ultrasonography) scan report (attachment removed to protect patient identity), there are still retained products of conception inside the uterus with clots. Ideally, you can take the remaining two doses of tablet Misoprostol and allow the bleeding to continue further, as with medical abortion, the bleeding may last for at least 7-10 days. Repeat ultrasound ideally after 2 weeks to check for retained products again. If the products are still retained, then dilatation and curettage would have to be done without delaying it further, as you said, till 2 months. Delaying can lead to endometritis or uterine infection, which can be harmful to future pregnancies.

Answer 2

Hello,

Welcome back to icliniq.com.

You should take it now. As products of conception are still there inside, and unless they all come out, your bleeding will not stop completely at all, and D&C (dilatation and curettage) would be the best to undergo, ideally, in such cases of failed medical management. You may try by taking the remaining pills sooner, or else get an early D and C done.