How to distinguish a gestational sac from fetal membranes in medication abortion?

Patient's question:

Today I accompanied my girlfriend to the hospital for medication-induced abortion. However, I don't know how to distinguish the gestational sac and fetal membrane from the things that come out. I don't know when I should call the nurse over?

Doctor's answer:

The surgical termination of early pregnancy using medication is typically performed when bleeding and abdominal pain have already started. It is important to carefully monitor the amount of vaginal bleeding and observe whether a gestational sac is expelled. Sometimes it can be difficult to distinguish between the gestational sac and the fetal membrane. The gestational sac is usually white and most commonly round or oval-shaped. When the gestational sac is expelled, abdominal pain tends to be more pronounced, and the amount of bleeding is usually higher. The gestational sac is typically expelled along with a significant amount of bleeding. After the gestational sac is expelled, bleeding often increases, and abdominal pain tends to decrease. If necessary, a follow-up ultrasound is usually required to rule out any residual tissue in the uterine cavity.

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