Patient's question:
On November 29th, I had a medication abortion. At that time, the gestational sac had already passed out, but more than two weeks later, I was still bleeding. When I went for an ultrasound, they said it wasn't completely passed and suggested a D&C. I was afraid of the pain and refused. The doctor gave me several days of oxytocin injections, but it didn't help much. I thought that if my period came in December, everything would be out and I'd be fine. But a few days ago, I suddenly passed large clots for two days, and I thought it was okay. After another week and a half, until now, there's still blood!Am I at risk of getting a disease? Will this condition leave any aftereffects? If the check-up still shows it's not completely passed, besides a D&C, are there any other methods?
Doctor's answer:
If the check still shows incomplete evacuation, a D&C (dilation and curettage) may be necessary.In the first 2–3 days after a miscarriage, vaginal bleeding is usually equivalent to or slightly heavier than a menstrual period. If the bleeding is excessive or persists, it is important to seek medical attention promptly.
### Causes and Management of Bleeding After Medical Abortion
Bleeding after medical abortion typically occurs within 1–3 weeks. The general pattern is: bleeding decreases day by day. However, if bleeding decreases and then increases again, stops completely, or gradually worsens, it is considered abnormal. Common causes include:
1. Incomplete Abortion: The most common reason for bleeding after medical abortion. It can usually be diagnosed through a gynecological examination and ultrasound.
2. Infection After Medical Abortion: If ultrasound confirms no residual tissue in the uterus, infection should be considered, as the blood from the miscarriage provides an ideal environment for bacterial growth. Severe cases may present with uterine tenderness during examination and symptoms such as fever.
3. Poor Blood Clotting Function: Some individuals are prone to bruising or swelling even with minor injuries, which may indicate poor blood clotting. During medical or surgical abortion, this can lead to excessive bleeding or prolonged bleeding.
Management: Due to the variety of potential causes, it is best to undergo a thorough examination at a hospital for an accurate diagnosis.