Brief Answer:
Wait for few days more : Report to Obstetrician

Detailed Answer:
Hallow Madam,

I could not get your name by your id. Will you please convey me your name?

For medical termination of pregnancy, usually tab. Mifepristone 200 mg is taken which is followed by Tab. Misoprostol after 24-48 hours, which you have done. These medicines are effective and safe to terminate the pregnancy up to 9 weeks of gestation. I hope you have taken the medicines in the prescribed dosages. Since your pregnancy is hardly 5 weeks, these medicines should terminate your pregnancy. However, these medicines should be taken only with the advice and supervision of Obstetrician to avoid the failure and complications. I hope you have done so. Usually termination (abortion) process starts within 24 hours; however in some cases it be delayed even up to 7 days. If it does not, you will have to report to the Obstetrician for further action, which may be any one of the following:

1. Repeat the same medicines and wait expectantly for few more days.

2. If this also fails, or otherwise also, surgical evacuation of the uterus is the assured option. In your case, it can be done by syringe suction.

I would like to inform you that consumption of these medicines is as good as a point of no return since these medicines are known to cause developmental abnormalities in the baby. Hence pregnancy should not be continued.

I would advise you not to rely on the pregnancy test on urine at this stage. Even after the baby becomes non-viable, it takes about 8-10 days for these tests to become negative. It requires that much time for the levels of the hCG hormone which is circulating in the blood to lower down. After these medicines, when the abortion process has started, we advise to confirm the completion of the abortion by ultrasonography. If at all it is incomplete, then surgical evacuation is required to complete it.

At this stage, my advice to you is to wait for few more days before taking any further action; however, you should report to the Obstetrician regarding the events.

Please keep me informed about the further events and progress. If by next 48 hours the abortion process does not start, we may have to take alternative decision of opting for surgical evacuation of the uterus.

In surgical evacuation, there is no scar any where. Vaginally the products are sucked by a suction syringe through the mouth of the uterus (cervix). In most of the cases this is performed without anaesthesia or under local anaesthesia. For 5 weeks pregnancy, I feel, no anaesthesia would be required.

I am sure this should guide you for your further actions. If you are satisfied, please post your remarks with 5 start rating for me. For any further guidance and information, I am always available for you.

Dr. Nishikant Shrotri

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Brief Answer:
Your next step should be only after consulting an Obstetrician

Detailed Answer:
Dear XXXXXXX XXXXXXX

If these medicines fail once, you can repeat them one more time; however only after the consultation with an Obstetrician. If this also fails, you will have to undergo evacuation of the uterus by MVA syringe or any other surgical method of the choice of your Obstetrician. As I had previously informed you, you cannot revert the decision to continuation of pregnancy since after these medicines, there is a risk of developmental abnormalities in the baby. Please do not ignore and neglect yourself. Report to the Obstetrician ASAP.

Dr. Nishikant Shrotri

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