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Suggest Treatment For Pain In Abdomen And Back After A Medical Abortion
Question: Could you please advise me on what painkillers are safe to consume during this time? I had taken a dose of 400mg ibuprofen yesterday and that gave me some relief for about 6 hours but I'm not sure if it is safe. I had also consumed meftal spas for the pain. Is it safe?
With regards to infections, what are some of the common antibiotics that should be taken to avoid them (my doctor has not prescribed any)
How would I know when I have passed the embryo out of my system?
Finally, could you please give me an estimate as to how many days these cramps would go on for?
Sorry I haven't given you the background. Here's the background information:
Hi I underwent a medical abortion in which I was given a combination of ru486 and ru487 (administered as a vaginal suppository 48hrs after being given ru486). The ru487 was administered 3 days ago and since then I have been having severe pain in my abdomen and back. The pain has increased a bit since yesterday. It is quite similar to the pain experienced during my menses but is more painful. Also, my belly has swollen up slightly. Please advise me. Am I at risk? Or is this usual?
Brief Answer:
the process of bleeding may continue for 2 weeks.
Detailed Answer:
Hi XXXX
You have undergone medical abortion. The pain like cramps occur after taking the drug but usually settles with antispasmodics. Ibuprofen and Meftal spas should work well, but if still pain is there you can take tab. Drotaverine with aceclofenac combination after consulting your treating dr.
I hope the period of gestation was within permissible limit of medical abortion. Did you get proper bleeding or passage of some clots or pieces? One more thing I will like to ensure is that you get your scan done before taking this medicine, as it very important to see that the pregnancy is intra- uterine only.
Usually no antibiotic is required along with this unless there is some evidence of infection. Any antibiotic and any pain killer is safe at this period as we are not continuing pregnancy .
It takes about 16 days for the embryo to pass out of your system and till that time bleeding may continue off and on. But of course, in case of heavy bleeding, you are supposed to report to your dr. immediately.
The cramps should settle in 3-4 days.
You are supposed to go for a follow up to your dr. after 16 days and she may get a repeat scan done to see that cavity is empty.
Thanks.
Above answer was peer-reviewed by :
Dr. Shanthi.E
He did not get ultrasound and said that ultrasound is necessary only when you want to keep a pregnancy. I questioned him about the intra uterine issue and he reassured me that the pregnancy was indeed intra uterine (i.e. he ruled out an ectopic pregnancy)
I was at the XXXXXXX 6 weeks pregnant he said. I have already used 10 pads - 2 after ru486 and 8 after ru487. Also, I passed 2-3 small fist big clots after ru486.
I experience heavy bleeding during my normal periods (usage: 6-7 pads) and also cramps on my first and second day for which I take 2 meftal spas each day. But the cramps this time have come with double the pain
The third visit is on 29th March. Can you advise what things should i get clear when i visit him then ?
Brief Answer:
get an ultrasound done in next visit.
Detailed Answer:
Hi XXXX Thanks for writing again.
It is good that it is confirmed that pregnancy is intra-uterine only,and period of gestation is also ok. But the patients who experience heavy periods and pain during their normal cycles also get this type of abortion as a bad period with extra bleeding and more cramps. Ru 486 is anti progesterone drug and misoprost is a prostaglandin which causes contraction of uterus and tries to expel everything out. Your feeling of this extra cramps is the side effect of this medicine.
During your visit to your dr. he himself will get all the things clear by getting blood test done to know your Haemoglobin and hematocrit and also your scan is must to know that you don't need anything else and the cavity is empty.Don't worry he will take care of all the things.
It is advisable not to have sex for these 2 weeks to avoid infection.
Thanks.Hopefully the things will be fine by your next visit.
Above answer was peer-reviewed by :
Dr. Prasad
Thank you Doctor for the answer.
I am actually having trust issues with the doctor because of the way he handled it.
I stay in Delhi and was on a vacation in Mumbai without my husband when I discovered the pregnancy.
Without the scan, He told me I was six weeks pregnant and had to take a decision immediately for successful medical abortion as I was running late.
When I gave him the go ahead, he immediately asked me to deposit 8000 rs.
I was neither physically or mentally in a state to visit other clinics and thus, gave him the go ahead after checking that the clinic and procedure was legal. After the payment, he interacted with me very minimally limiting his answers to yes or no. Thus, I am very concerned about what all should be done to confirm that the medical abortion has undergone successfully ?
Also, I am a regular smoker (1-2 cigarettes a day). So when can I resume smoking given that ru486 was given on 21st march and ru487 on 23rd ?
If he gives me the clear on 29th March, then when should I get myself checked again to confirm that I dont have any infections ?
If the termination is not complete, then will I have to go for a surgical abortion ?
In that case, can I wait for 2-3 days and do it in Delhi from some other doctor ? ( I will be in delhi on 2nd April)
And lastly, how can I confirm that my uterus and other things are in the right condition to get pregnant during a later stage in my life ?
Also, I feel 8000 Rs. is a little on the higher side. Can you tell me what are the rates for medical and surgical abortion ? Also, acc. to me he should not ask me to pay extra for the ultrasound and should include in the package. So can you also let me know what is the charge for ultrasound scan ? Thank you for all your help
Brief Answer:
have faith in your doctor
Detailed Answer:
hi XXXX Being a dr. myself I will request you to have faith in your treating dr.
Actually a patient is always more comfortable with his or her own dr. and has a good rapport with him. But I think your experience was not so good with a new person. Believe me no dr. would ever try to harm or worsen his patient. He must have judged 6 weeks pregnancy by doing a per vaginum examination and considering that it is not ectopic by palpation and according to your history or symptoms.
Regarding payment issues I cannot comment anything. Everyone has his own way of treating and charging.May be he includes the scan charges or any procedure required at a later stage in this. I really don't know or tell you anything about this.
You can simply re-visit him and clear all such issues please.
To confirm that medical abortion has been done successfully the only way is to see by a scan.Now, for TVS also different rates are there in different cities.
Usually in our city they are charging around 1000/Rs. I cannot say about Mumbai or Delhi.
To rule out any infection you can get your CBC and urine routine examination and
also scan will indicate.
If you really need any surgical thing, and you are not bleeding much , you can wait and get the things done at Delhi.2-3 days will not make much difference.
You should ideally quit smoking for your future health and you are yet to have another baby.
I don't think this medical abortion will have any impact in conceiving in future. Don't worry so much.Be cool and good luck.
Thanks.
Above answer was peer-reviewed by :
Dr. Shanthi.E
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