Brief Answer:
Complete the kit under care of Gynecologist.

Detailed Answer:
HI XXXXX,
Thanks for the query through HCM forum.
I understand your query & concern.
* Unwanted kit is a combination of medicines for medical abortion before 49 days of pregnancy. You have taken it at about 22 days of pregnancy.( in time)
The kit contains two type of pills
- One pill of Mifepristone - it acts by removing blood supply to the fetus, so as to make it nonviable. this just kills /separates the pregnancy from uterus This does not cause bleeding.
- There are four pills of 200 mg of Misoprostol - This brings about uterine contractions & starts expelling the separated products of conception & so the bleeding starts after the Misoprostol pills .
* How to use the kit-
- get pregnancy confirmed,
- consult a gynecologist for medical termination of pregnancy,
- Take the pill of Mifepristone on half filled stomach. Avoid vomiting the pill( for vomiting may loose the pill & there wont be desired effect on pregnancy.) one can chew beetle nut/ clove to avoid vomiting.
_ After exactly 24 hours of Mifepristine pill ,take 2 pills of Misoprostol 200 mg pills. Repeat 2 more Misoprostol 200 mg pills after 24 hours again.
The whole course should complete in 72 hours.
* Abortion-
-Bleeding starts after The MIsoprostol pills are taken ,due to the contraction of uterus & throwing out of separated products start & process completes in 3-4 days.
* Now, your problem is-- you took Tab. Mifepristin & waited for the bleeding to start. It has just caused separation of fetus from maternal contact.... The bleeding will start after the next pills ( MIsoprostol.)
* Way out of the problem. - I don't know how many days have lapsed after taking first pill. The pills taken in sequence at given interval facilitates smooth expulsion of the pregnancy.
- Still a chance can be given by taking tab Misoprostol 200mg -2 pills & wait for the bleeding to start. Follow it with another 2 pills of Misoprostol ( if there is no expulsion in 24 hours).
- Mostly the abortion would be complete with 3-4 days of heavy bleeding, b BUT if the separated fetus gets stuck to uterine cavity ( because of delay in uterine contractions- as the Misoprostol was not taken in time)-The process may not complete just with medicines & you may need a Gynecologist's help & surgical evacuation of the pregnancy.
** looking at the situation & it's possible out come.. I would advise you to consult a Gynecologist (for examination / investigations like USG scan/ blood Hb%, grouping ) BEFORE you take Misoprostol pills. & to complete the kit under an expert care is safer. You will have to see your gynecologist -
- In case there is profuse bleeding/ unbearable pains during the process.
- If the contractions do not start after MIsoprostol OR the abortion is incomplete & bleeding continues for a longer time.
* above two conditions may need surgical intervention.
- For internal check up after the abortion is complete( to confirm it)
- A follow up check up after next menses & consultation & adoption of suitable contraceptive device hence forth.
I have tried to inform you about use & effect of Unwanted kit in detail, so as to understand your situation. I hope it prooves to be helpful to you.Any follow up query is welcome. Take care.
Thanks.

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Brief Answer:
You need tests to check for pregnancy first

Detailed Answer:
Hi,

Thanks for the follow up query.

Oh, you have not tested for pregnancy yet? Amazing! In last query itself I had informed about pregnancy confirmation before starting the Unwanted kit. I also suggested for consulting a gynecologist before taking Misoprostol pills . Probably you had skipped that from previous answer & taken the pills on your own without any bleeding..This can happen due to two causes in her case-

1) There was no pregnancy, you had taken the Unwanted pills without confirmation of pregnancy...& as there is nothing to be aborted there is no bleeding, but just uterine contractions.
2) the pregnancy was present, you took the Mifepristin pill from Unwanted kit ( without a doctor's consultation).. It served it's work..to separate the embryo from maternal connection. But it lied there without expulsion (as the misopristol was not taken in time ).. & got adhered to uterine walls so much that... Even the misopristol taken later could not expel it out in spite of uterine contractions & taking two more pills would be harmful if there was no pregnancy.

Still I assure you not to worry. She will be alright if managed properly. Looking at the present condition...You need to consult a gynecologist before you take more misoprostol for diagnosing the presence or absence of products of conception present in uterus by
- USG scan. ( pregnancy test will not be + ve now as the Mifepristin had
killed it )
- By internal examination by an expert gynecologist.

Once doctor knows about retained products of conception Or absence of pregnancy.. further management can be planned under her expert guidance. It can be-
1) If pregnancy was +ve :admission with IV drips along with medicines to cause uterine contractions & expulsion of products. OR surgical evacuation of uterus.. Along with antibiotics & other medicines as per need.
2) If pregnancy was -ve : your friend would be investigated for irregular periods & treated to regularize her cycle.

Have you got the point now? I have tried to give the possibilities clearly. I hope the information is useful to you & helps you in taking decision.Any follow up query is welcome.If you are satisfied, please grade the answer before you close the query.

Thanks

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