Patient's question:
Detailed medical condition and consultation purpose: I had a medication abortion a month ago. After half a month, I had sexual intercourse, and there was a small amount of bleeding, but it stopped the next day. Since then, I haven't noticed any bleeding. Now, 12 days have passed, and there is a small amount of bleeding again. Initially, it was red, but now there is a small amount of brown discharge, but it is very minimal. What is wrong with me?Doctor's answer:
Hello: Generally, the average duration of bleeding after the expulsion of the gestational sac in medication abortion is 18 days. The reasons for prolonged bleeding may include incomplete shedding of the decidua, which affects uterine contraction and hemostasis; or incomplete expulsion of the gestational sac, leading to incomplete abortion. In some cases, post-abortion infection may occur, resulting in endometrial inflammation.If bleeding does not stop two weeks after the expulsion of the gestational sac, a urine pregnancy test and ultrasound examination should be performed. If incomplete abortion is diagnosed, a Dilation and Curettage (D&C) procedure should be conducted. If the bleeding persists due to incomplete shedding of the decidua but the bleeding is minimal upon consultation, medication or oxytocin injections can be administered to promote uterine contraction and expel residual decidua tissue. Bleeding will only stop when the embryonic tissue in the uterine cavity is largely expelled and uterine contraction is effective.
It is important to note that women undergoing medication abortion may sometimes experience a sudden increase in bleeding, several times the amount of a normal menstrual period, accompanied by large blood clots. This is due to the incomplete detachment and expulsion of embryonic tissue, and immediate medical attention is required, with a D&C procedure being performed to stop the bleeding. Vaginal bleeding after medication abortion may sometimes be intermittent. Patients should not assume they can swim or engage in sexual activity simply because there is no bleeding, as this is incorrect. Whether undergoing medication abortion or surgical abortion, swimming and sexual activity should not be resumed until after a normal menstrual period. Otherwise, there is a risk of developing pelvic inflammatory disease.