Is it normal to have no residual bleeding after medical abortion?

Although medical abortion causes less damage to women's uterus than other abortion procedures, it also faces the problems of low success rate and incomplete removal of the gestational sac. Therefore, women will experience symptoms of genital bleeding for a period of time after undergoing medical abortion. However, if the symptoms of lower body bleeding last for a long time, it may also be due to an abnormal condition in the woman's body and should not be taken lightly.

1Mechanism of medical abortion

Medical abortion is a method of terminating early pregnancy by taking 6 tablets of the oral anti-progestin drug mifepristone (Xiyin, Hanzhuting) combined with 3 tablets of misoprostol. Mifepristone has the effects of preventing the implantation of the fertilized egg, inducing menstruation and promoting cervical ripening. Its mechanism of inducing menstruation and stopping pregnancy is mainly through competing for the progesterone receptors of the endometrium (decidua), blocking the effect of progesterone, causing the decidua of pregnancy to degenerate, bleed, and necrotize, until miscarriage. Misoprostol acts on uterine contraction, causing the detached embryonic sac to be expelled from the uterus.

2Who is suitable for medical abortion?

⑴Confirmed as normal intrauterine pregnancy;

⑵ The number of days of amenorrhea is less than 49 days (calculated from the first day of the last menstrual period);

⑶Being younger than 40 years old;

⑷ High-risk subjects for surgical abortion: such as those with reproductive tract malformation, severe pelvic malformation, cervical dysplasia, caesarean section within six months, postpartum breastfeeding, multiple abortions or curettage history;

⑸ Those who are afraid of surgical abortion;

⑴ Suffering from diseases that are contraindicated for medical abortion drugs: such as adrenal disease, diabetes, liver and kidney dysfunction, blood disease, history of vascular embolism, hypertension, heart disease, glaucoma, epilepsy, asthma, etc.;

⑵ Ectopic pregnancy or suspected ectopic pregnancy;

⑶Allergic constitution;

⑷ Pregnancy with IUD;

⑸ Long-term use of rifampicin, remifentanil, anti-epileptic drugs, antidepressants, cimetidine, aspirin, indomethacin, barbiturates, etc.;

⑹ Smoking more than 10 cigarettes a day or being addicted to alcohol; (There are reports abroad that smoking women died during medical abortion)

⑺ Those who cannot seek medical treatment and follow-up in time;

⑻The average diameter of the fetal sac is greater than 2.5cm;

⑴Easy to use;

⑵ The application is safe and there is no intrauterine operation for surgical abortion; (3) There is no fear of surgical curettage.

5About 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 tissue in the uterus: the gestational sac, where the fetus will grow in the future; and 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.