What should I do if the abortion is not clean?

Many people who are pregnant when they are no longer able to raise a child usually choose to have an abortion. Some go directly to the hospital for an abortion, while others choose the relatively cheap medical abortion. However, sometimes medical abortion may not be complete. So what should you do at this time? Next, I will explain to you what to do if the medical abortion is not complete.

Regarding medical abortion, only women who are allowed to undergo medical abortion in outpatient clinics within 49 days of pregnancy are allowed to do so. At this time, there are two types of pregnancy tissues in the uterus, one is the gestational sac, where the fetus will grow in the future; the other is the decidua.

The purpose of medical abortion is to prevent the fetal sac from continuing to grow and develop in the uterine cavity and to expel it from the body through uterine contraction. If the fetal sac is seen being expelled during the medical abortion process, it can be considered that the medical abortion is basically completed.

However, since the decidua attached to the inner wall of the uterus has not been completely discharged with the gestational sac, the contraction of the uterus is affected and the bleeding will not stop immediately, especially in the first three days after miscarriage, when there is more bleeding, which will gradually decrease afterwards.

Generally speaking, the average number of days of bleeding after the expulsion of the gestational sac after medical abortion is 18 days. In some cases, the bleeding time may be longer. The reasons for the long bleeding time may be incomplete decidua detachment, affecting uterine contraction and hemostasis; or incomplete expulsion of the gestational sac, leading to incomplete abortion; a small number of patients are infected after medical abortion surgery, resulting in endometrial inflammation.

According to regulations, you should go to the medical abortion unit for a follow-up visit two weeks after the gestational sac is expelled. If the bleeding has not stopped at this time, urine pregnancy and delivery tests and B-ultrasound examinations are needed. Those diagnosed with incomplete abortion should undergo a curettage. Vaginal bleeding will stop within 10 days after the operation. If the bleeding does not stop, it is caused by incomplete decidua exfoliation, but the bleeding is not too much when you see the doctor. You can take Motherwort Paste or Gongxuening or Chinese medicine Shenghua Tang. These Chinese medicines can stop bleeding and reduce inflammation, and can help the uterus contract, thereby helping the uterus to expel intrauterine residues out of the uterus.

Oxytocin can also be injected intramuscularly to promote uterine contractions to expel remaining decidual tissue. For patients whose bleeding is 2-3 times more than the menstrual volume and whose bleeding does not decrease after conservative treatment, uterine curettage should be performed in time. Some patients believe that if they suffer from excessive bleeding after medical abortion, they can simply take hemostatic drugs such as Anluoxue and Zhixuemin. This is incorrect. Because hemostatic drugs achieve the purpose of stopping bleeding by changing the body's coagulation mechanism, they cannot expel residues in the uterine cavity and therefore cannot fundamentally solve the problem. Bleeding will stop only when the embryonic tissue in the uterine cavity is basically discharged and the uterus contracts well. It is worth noting that women who have undergone medical abortion sometimes suddenly experience a significant increase in bleeding, which may be several times the amount of menstrual bleeding, accompanied by large blood clots. This is caused by the exfoliation of embryonic tissue and poor excretion. At this time, they need to go to the hospital immediately for a curettage to stop the bleeding. Even if the abortion is complete and the gestational sac has been expelled, there will still be a lot of bleeding in the first 2 or 3 days, which may be equivalent to or slightly more than the menstrual volume. This is normal and the bleeding will gradually decrease afterwards.

Do not mistakenly believe that heavy bleeding in the first 2 or 3 days means that the bleeding is not complete or the gestational sac has not been expelled, and then perform a uterine curettage easily, causing unnecessary pain to women. As long as the bleeding is not very heavy, that is, more than 3 times the menstrual volume, do not perform uterine curettage for the time being, but observe closely, or give emergency conservative treatment measures first, because 10% of people will expel the gestational sac within a week. Because medical abortion causes prolonged bleeding, the cervix relaxes, providing an opportunity for bacterial growth and retrograde infection.

Therefore, if vaginal bleeding lasts for more than 7 days, antibiotics should be taken routinely for 3 to 5 days to prevent infection. A small number of patients do not pay attention to hygiene after medical abortion, and swim or have sex when the amount of bleeding is small or the bleeding has temporarily stopped, resulting in uterine cavity infection and endometritis. At this time, the patient's vaginal bleeding may not be heavy, but it may have a fishy smell, may be mixed with yellow secretions, or may be accompanied by dull pain in the lower abdomen. Treatment requires adequate antibiotics and the administration of motherwort paste or Shenghua Tang to promote the expulsion of unexpelled embryonic tissue as soon as possible. After the inflammation is controlled, if B-ultrasound examination confirms that there is still residual tissue in the uterine cavity, curettage can be performed and anti-inflammatory treatment can be continued after the operation. Vaginal bleeding after medical abortion often occurs intermittently. Patients should not think that they can swim or have sexual intercourse just because there is no vaginal bleeding. This is wrong. Whether it is medical abortion or artificial abortion surgery, swimming and sexual intercourse should be performed after a menstrual period. Otherwise, it may lead to pelvic inflammatory disease.

What should I do if I don't see the fetal sac expelled after medical abortion?

(1) If you have a lot of bleeding within a few hours after taking misoprostol, but the bleeding is gradually decreasing now, it means that the gestational sac has been discharged, but you did not see it at the time. The blood is white and about the size of your own fingernail. Sometimes it is wrapped in a blood clot, and you cannot see it without washing the blood clot with water. If the gestational sac has not come out, the bleeding will not decrease, but will continue to increase. Go buy Gongxuening now, take two pills at a time, once every 6 hours, for 7 days. This medicine can reduce inflammation, stop bleeding, help the uterus contract, and expel residual tissue, with a relatively good effect. You can also take motherwort paste or motherwort powder. Take some anti-inflammatory drugs, such as norfloxacin, 0.4 grams at a time, twice a day, for 7 days; or take amoxicillin, 0.5 grams at a time, once every 8 hours, for 7 days. Note: People who are allergic to penicillin should not take it. Check again after 15 days. If the result is negative, it is clean. If the result is positive, it is not clean and you need to have another uterine cleaning. After such treatment, most of them will be fine.

(2) If there is little or no bleeding a few hours after taking misoprostol, it means that the fetal sac has not been expelled. You can take another 3 tablets of misoprostol. If the fetal sac is still not seen coming out after 6 hours, observe for a few more days, because 10% of people can be expelled within a week. If the fetal sac is still not expelled after a week, you should go to the hospital for a uterine cleaning.

The above is an article that explains what to do if medical abortion is not complete. I hope that after reading the above article, everyone can have a comprehensive understanding of medical abortion. However, the editor still recommends that everyone go to a regular hospital for abortion to prevent the occurrence of these diseases.