No bleeding for a few days after abortion

When women have an unexpected pregnancy, they will have an abortion. Although this operation is relatively small and very safe, it can cause great harm to women's bodies. Vaginal bleeding will continue at the beginning. Don't panic too much at this time. Observe your body changes closely and go to the hospital in time if you find any abnormal reactions.

Mechanism of action

Mifepristone has an anti-progesterone effect. Its affinity for the endometrial progesterone receptor is significantly higher than that of progesterone. Therefore, it can compete with the progesterone receptor in the decidua, block the activity of endogenous progesterone, and interfere with pregnancy. Due to the necrosis of the decidua during pregnancy, endogenous prostaglandins are released, which promote uterine contraction, cervical softening and opening, and the expulsion of the fetal sac.

The prostaglandins used in my country are misoprostol and carboprost methyl suppositories; abroad there are also gemeprostol and sulfaprostone. Different regions have slightly different regulations on the gestational age at which medical abortion can be performed. Taking Beijing as an example, women with a gestational age of less than 49 days can have a medical abortion in an outpatient clinic. However, patients with a gestational age of 10-16 weeks have a higher risk of bleeding during forceps curettage, so they have begun to use mifepristone combined with prostaglandins for medical induction of labor, but they need to be hospitalized.

Indications

1) Healthy women aged 18-40 years who are diagnosed with normal intrauterine pregnancy (last menstrual period ≤ 49 days) and voluntarily request to use medication to terminate pregnancy; 2) High-risk candidates for artificial abortion, such as those with reproductive organ malformations (except rudimentary uterine horn), severe pelvic deformity, extremely tilted uterus, cervical dysplasia or tough uterus, scarred uterus, multiple artificial abortions, etc. (Note: Even if these patients choose medical abortion, they still have high-risk factors for medical abortion. The failure rate of medical abortion and the chance of post-abortion bleeding are higher than those of patients without high-risk factors); 3) Those who have concerns or fears about surgical abortion.

Contraindications

1) Contraindications of mifepristone: endocrine diseases such as adrenal glands, diabetes, thyroid glands, abnormal liver and kidney function, history of skin itching during pregnancy, blood diseases and vascular thrombosis, and tumors related to steroid hormones; 2) Contraindications of prostaglandins: cardiovascular diseases such as mitral stenosis, hypertension, hypotension, glaucoma, gastrointestinal dysfunction, asthma, epilepsy, etc., or those who are allergic to prostaglandins; 3) Those with allergic constitutions and those with severe vomiting during pregnancy; 4) Those with anemia and hemoglobin levels of 100g/L or below; 5) Those with pregnancy with an IUD; 6) Those with ectopic pregnancy or hydatidiform mole

7) Those who smoke more than 10 cigarettes a day or are alcoholics; 8) Those who travel frequently, come to Beijing from other places, live far away from medical institutions, and cannot seek medical treatment and follow-up in time; 9) Those with untreated genital tract inflammation, such as vaginitis, acute suppurative cervicitis or subacute cervicitis, acute or chronic pelvic inflammatory disease, sexually transmitted diseases, etc.

Pre-medication treatment

1) The doctor should explain the medication method, efficacy and possible side effects to the recipient, and the recipient can make a voluntary choice; 2) Physical examination and testing are the same as vacuum aspiration; 3) The pros and cons of medical abortion should be explained to pregnant women, and they can make a natural choice.