Hallow Dear,
After reading your history I have understood that due to the complications during last delivery, continuation of any more
pregnancy is highly risky for you.
Since now you have missed your periods by 4 days, your first aim would be to find out whether you have conceived or your periods are just delayed due to some other cause. Since the
pregnancy tests on the urine requires about a week to give reliable results, I would advise you to go for
Beta hCG test which at this stage would definitely give reliable information about the status of your pregnancy without wasting more days for disgnosis.
If you are pregnant, you have two options: Medical or Surgical Methods to terminate this pregnancy. Considering the condition of your previous scar, surgical methods should be avoided as far as possible.
You may choose Medical methods. They are quite safe and effective up to 9 weeks of pregnancy. At such an early stage of less than 5 weeks of pregnancy, scar rupture due to uterine contractions is a very remote possibility. For medical termination, you have two options:
1. Tab. Mifepristone followed after 24-48 hours by Tab. Misoprostol
2. Tab. Misoprostol every 3-12 hours up to 3 doses.
These medicines are prescription medicines. Please buy them only with a Gynaecologist's prescription. Also please get precise instructions from Gynaecologist about the dosage, schedule and routes of administration of these medicines. Usually these medicines cause an
abortion within 24 hours but not later than 3 days of the last dose of Tab. Misoprostol.
Ultrasonography for the confirmation of completion of abortion would be a good step. Also, I would advise you to have a follow up visit to the Gynaecologist 7 days after the last dose of Misoprostol - irrespective of the status of abortion.
However, these medicines cause developmental abnormalities in the baby; hence in case of failure of the medicines, please do not continue pregnancy. Then surgical aspiration of the products of conceptions by MVA is mandatory for your. This is comparatively safer procedure with less chance of perforation of the scar at the expert hands.
If Beta hCG test revels you are not pregnant, you can safely wait for your menses to appear. If they do not appear naturally, you may take Tab.
Deviry for 5 days and the within 4-7 days you would get withdrawal bleeding.
After this dilemma is over, please adapt some good reliable
contraceptive method to prevent such risky situations in future. I would advise you to go for dual protection by birth control pills and condom. Alternatively, either of you may choose to get sterilized.
I am sure, you have got the required guidance.
Dr. Nishikant Shrotri