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What Causes Vaginal Bleeding And Irritation After Having Cytotec?

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Posted on Mon, 22 Sep 2014
Question: Hi. I had a miscarriage 3weeks ago induced by Cytotec vaginally. i was about 8 weeks along with my pregnancy. I am still currently bleeding and have pain, irritation and discomfort. My doctor started me on antibiotic for suspected endometritis. After being on the antibiotic for over 5 days I still do not have any symptom relief. Since my doctor is out of office until next week I am feeling anxious and not sure where to turn for help. I have not had an ultrasound to confirm that all "products" have been evacuated. My HCG levels are at 600. At this point I am concerned that I have an incomplete miscarriage and I will have to either do another dose of Cytotec or a D&C. Any thoughts? Thanks!
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Answered by Dr. Shanti Vennam (18 minutes later)
Brief Answer:
Please get an ultrasound and swab.

Detailed Answer:
Hi,

Thanks for posting your query.

If you have had a guided medical abortion, chances of infection are low. Yet, you still have a chance of an incomplete abortion as you have had the abortion beyond the recommended 7 weeks window. Though, medical abortion can be performed up to 9 weeks, chances of incomplete evacuation become higher after 7 weeks.

In the current scenario, I would suggest a trans-vaginal sonogram under antibiotic cover to look for any retained products. If positive, the ideal treatment would be to go for a surgical evacuation under sterile precautions and get a confirmation sonogram. Styptics may also be needed to control the bleeding. General nutrition must be maintained and so are nutritional supplements. A vaginal swab may also be needed if vaginitis is suspected, with the antibiotic mentioned.

Serum beta-hCG levels remain high for a couple of weeks before they begin to decline. Serial titres are needed to confirm the completion of the abortion. Declining titres indicate a successful abortion.

Hope I have clarified your query. Please feel free to contact for further information. I will be happy to help.

regards,
Shanti.V.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Shanti Vennam

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Practicing since :1989

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What Causes Vaginal Bleeding And Irritation After Having Cytotec?

Brief Answer: Please get an ultrasound and swab. Detailed Answer: Hi, Thanks for posting your query. If you have had a guided medical abortion, chances of infection are low. Yet, you still have a chance of an incomplete abortion as you have had the abortion beyond the recommended 7 weeks window. Though, medical abortion can be performed up to 9 weeks, chances of incomplete evacuation become higher after 7 weeks. In the current scenario, I would suggest a trans-vaginal sonogram under antibiotic cover to look for any retained products. If positive, the ideal treatment would be to go for a surgical evacuation under sterile precautions and get a confirmation sonogram. Styptics may also be needed to control the bleeding. General nutrition must be maintained and so are nutritional supplements. A vaginal swab may also be needed if vaginitis is suspected, with the antibiotic mentioned. Serum beta-hCG levels remain high for a couple of weeks before they begin to decline. Serial titres are needed to confirm the completion of the abortion. Declining titres indicate a successful abortion. Hope I have clarified your query. Please feel free to contact for further information. I will be happy to help. regards, Shanti.V.