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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Heavy Vaginal Bleeding,cramps And Nausea After A Chemical Abortion?

Hi, I did a chemical abortion nearly 3 weeks ago and I am wondering if the symptoms I have had are normal. I had heavy cramps and light to medium bleeding for at least 8 hours after the mifeprostone pills. The bleeding continued for about 5 days after that. I didn't feel pregnant at all, only weak with some cramps. A week after that I started to get some heavier cramps which I thought were maybe with my period trying to come back. There was some slightly colored discharge, with no odour that i could notice, with those cramps which lasted a few days on and off, but no bleeding. Now I feel a heaviness or still a swolleness and slight pangs of cramps now and then. I have very slight nausea sometimes which make me nervous that I am still pregnant. Would a urine test at 3 days before the 3 week mark after the abortion give an accurate reading on whether or not I was pregnant still or needed further treatment? I am in Ireland and it is difficult to get an ultrasound. thank you.
Fri, 8 Jul 2016
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General & Family Physician 's  Response
Hello dear
Understand your concern
Anyway you have to go for USG as you have vaginal bleeding, cramps and nausea because it make your life in dangerous.
Yes pregnancy test 3 day before week after abortion give correct result (negative) if you abort successfully.
But following are the causes of you problem:
1. Incomplete abortion: should be diagnosed by USG and treatment is misoprostol or D & C.
2. Ectopic pregnancy: chemical abortion fails to abort the ectopic pregnancy so remaining pregnancy bleed continuously. Diagnosis should be made by USG and treatment is surgery with blood transfusion
3. Molar pregnancy: some time placental cell concert in to malignant cell by invasion. It should be diagnosed by USG and HCG titer. Treatment is surgery plus chemotherapy.
4. Infections: retain products increase risk of infections. Should be diagnosed by swab test, CBC. Treatment is antibiotic like cefurexime.

If all above cause are rule out and still bleeding continue, should be treated by Tranexamic acid after proper evaluation.
Hope this may help you
Best regards
Dr. Sagar
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What Causes Heavy Vaginal Bleeding,cramps And Nausea After A Chemical Abortion?

Hello dear Understand your concern Anyway you have to go for USG as you have vaginal bleeding, cramps and nausea because it make your life in dangerous. Yes pregnancy test 3 day before week after abortion give correct result (negative) if you abort successfully. But following are the causes of you problem: 1. Incomplete abortion: should be diagnosed by USG and treatment is misoprostol or D & C. 2. Ectopic pregnancy: chemical abortion fails to abort the ectopic pregnancy so remaining pregnancy bleed continuously. Diagnosis should be made by USG and treatment is surgery with blood transfusion 3. Molar pregnancy: some time placental cell concert in to malignant cell by invasion. It should be diagnosed by USG and HCG titer. Treatment is surgery plus chemotherapy. 4. Infections: retain products increase risk of infections. Should be diagnosed by swab test, CBC. Treatment is antibiotic like cefurexime. If all above cause are rule out and still bleeding continue, should be treated by Tranexamic acid after proper evaluation. Hope this may help you Best regards Dr. Sagar