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Medical Abortion Care - Topic Overview

Care after a medical abortion continued...

Call your doctor for an appointment if you have had any of these symptoms after a recent abortion:

  • No bleeding. If bleeding does not occur, then the medicines may not be working. A second dose of misoprostol may be needed. Methotrexate and misoprostol may take up to 3 weeks to be effective.
  • Bleeding (not spotting) for longer than 2 weeks
  • New, unexplained symptoms that may be caused by medicines used in your treatment
  • No menstrual period within 6 weeks after the procedure
  • Signs and symptoms of depression. Hormonal changes after a pregnancy can cause depression that requires treatment.

Complications that can occur include:

  • Tissue remaining in the uterus (retained products of conception). Cramping belly pain and bleeding will occur again within a week of the procedure.
  • Infection. Symptoms of fever of 100.4°F (38°C) or higher, pain, and belly tenderness will usually start within 2 to 3 days of the procedure. But you can have a serious infection without fever.
  • Blood clots blocking the cervix (hematometra). If the uterus doesn't contract to pass all of the tissue, the cervical opening can become blocked. This prevents blood from leaving the uterus. The uterus will become enlarged and tender. Belly pain, cramping, and nausea may be present.
  • Moderate to severe bleeding (hemorrhage). Bleeding may be more than normal if:
    • Products of conception are retained in the uterus.
    • The uterus has not contracted toward its prepregnancy size (atony).
    • Uterine muscle rupture has occurred. In rare cases, a uterine incision scar tears open when a medicine is used to induce contractions.

When a medical abortion fails, a surgical abortion must be done as follow-up to prevent complications or development of a fetus with abnormalities.

Follow-up examination after a medical abortion

A follow-up examination is done about 2 weeks after a medical abortion. The examination may include:

  • A physical exam, to check the cervix and uterus camera.gif.
  • A lab test to check for a low human chorionic gonadotropin (hCG) level, which shows the pregnancy has ended.
  • A blood test, to check for anemia.
  • An ultrasound, to confirm the uterus is empty.
  • A discussion of birth control use. If birth control measures were started immediately after the abortion procedure, the proper use of the method can be discussed again.

WebMD Medical Reference from Healthwise

Last Updated: August 31, 2012
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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