Hallow Dear,

Medicines can terminate the pregnancy only in the uterine cavity; any pregnancy outside uterine cavity (ectopic pregnancy) cannot be terminated by these medicines.

Since even after more than 2 weeks after the bleeding following medicines the pregnancy test is positive, definitely there is viable pregnancy somewhere in the body, - mostly ectopic pregnancy. In ectopic pregnancy, one line in the pregnancy test is lighter (weak positive). This is a very serious condition. It usually ruptures and the bleeding is alarming requiring surgical intervention with blood transfusion.

Please get ultrasonography done. If the uterine cavity is empty, the diagnosis of ectopic pregnancy is almost sure. Laparoscopy will confirm the diagnosis. If it is unruptured ectopic pregnancy, it can be very easily managed conservatively by medicine called as Methotrexate.

If the uterine cavity contains the products of conception, positive test suggests that the pregnancy is still viable. Since you have taken Mifepristone and/or Misoprostol, you should not think of continuing the pregnancy as these medicines cause developmental abnormalities in the baby. So it would be advisable to go for surgical evacuation of the uterus by MVA or so.

Please report to the Obstetrician ASAP.

I hope you got the message.

Dr. Nishikant Shrotri

Hallow Dear,

If her abortion was complete by 12/06, her pregnancy test should have become negative by 01/07. The test is weak positive. This is suggestive of following conditions:

1. Ectopic pregnancy: The pregnancy was outside the uterine cavity. The medicines Mifepristone and Misoprostol can terminate the pregnancy from the uterine cavity; not the one which is implanted outside the uterine cavity (ectopic pregnancy). Such pregnancy shows week positive results of pregnancy test. Commonly such pregnancy is in tube; though it may be present in other organs also.
Ectopic pregnancy does not grow very far and carries a risk of rupture of the tube. This is a bleeding emergency requiring number of units of blood transfusion and surgical intervention.

2. Continuation of pregnancy: Which will show positive pregnancy test; not the weak positive.

3. Development of Cancer of the chorionic tissue (Choriocarcinoma): In this condition, the hCG hormones are very high and hence the pregnancy test would be strong positive.

I feel you should get ultrasonography done. It will reveal whether there are any products in the uterine cavity; if so, they will have to be removed by surgical technique. If the uterine cavity is empty, the chances of ectopic pregnancy are very high. In such case, please undergo Laparoscopy. If the ectopic pregnancy is unruptured, it may be tackled by Laparoscopic microsurgery; otherwise it can be treated conservatively by Methotrexate.

Please report to your Gynaecologist ASAP to get diagnosed and treated before any emergency situation arises.

I hope you get the message.

Dr. Nishikant Shrotri