What to do if you have excessive bleeding after medical abortion

If the fetal sac is seen to be expelled during the medical abortion, it can be considered that the abortion is basically completed. However, since the decidua attached to the inner wall of the uterus has not been completely expelled with the fetal sac, the contraction of the uterus is affected and the bleeding will not stop immediately. Generally, the average number of days of bleeding after the fetal sac is expelled during painless medical abortion is 18 days. The reasons for the long bleeding time may be incomplete decidua peeling, which affects the contraction and hemostasis of the uterus; or incomplete fetal sac expulsion, resulting in incomplete abortion; a small number of patients are infected after medical abortion and endometrial inflammation occurs.

According to regulations, patients should go to the medical abortion unit for a follow-up visit two weeks after the fetal sac is expelled. If the bleeding has not stopped at this time, urine pregnancy and delivery tests and B-ultrasound examinations are required. Patients diagnosed with incomplete abortion should undergo uterine curettage, and vaginal bleeding will stop within 10 days after the operation. If the bleeding does not stop due to incomplete decidual exfoliation, but there is not much bleeding when you see the doctor, you can take motherwort paste or Chinese medicine biochemical soup, or you can inject oxytocin intramuscularly to promote uterine contraction to expel the remaining decidual tissue. Patients with more bleeding than menstrual volume generally need uterine curettage. Some patients believe that to treat the bleeding after medical abortion, they only need to take hemostatic drugs such as Anluoxue and Zhixuemin, which is wrong. Because hemostatic drugs achieve the purpose of hemostasis by changing the coagulation mechanism in the body, they cannot expel the residues in the uterine cavity, so they cannot fundamentally solve the problem. Bleeding will only stop when the embryonic tissue in the uterine cavity is basically expelled and the uterus contracts well. It is worth noting that women who have undergone medical abortion sometimes suddenly experience a significant increase in bleeding, which may be several times the amount of menstrual bleeding, accompanied by large blood clots. This is caused by the exfoliation of embryonic tissue and poor excretion. At this time, they need to go to the hospital immediately for a curettage to stop the bleeding.

Since painless medical abortion lasts for a long time, the cervix relaxes, which provides opportunities for bacterial growth and retrograde infection. Therefore, if vaginal bleeding exceeds 7 days, antibiotics should be taken routinely for 3 to 5 days to prevent infection. A small number of patients do not pay attention to hygiene after medical abortion, and swim or have sex when the amount of bleeding is small or the bleeding stops temporarily, resulting in uterine cavity infection and endometritis. At this time, the patient's vaginal bleeding may not be large, but it has a fishy smell, may be mixed with yellow secretions, or accompanied by lower abdominal pain. Treatment should be given sufficient antibiotics, and take motherwort paste or Shenghua Tang to promote the discharge of undischarged embryonic tissue as soon as possible. After the inflammation is controlled, if B-ultrasound examination confirms that there is still residual tissue in the uterine cavity, curettage can be performed, and anti-inflammatory treatment can be continued after surgery.

Experts remind that vaginal bleeding after medical abortion often occurs from time to time. Patients should not think that they can swim or have sex just because there is no vaginal bleeding. This is wrong. Whether it is medical abortion or artificial abortion surgery, swimming and sex should be done after a menstrual period. Otherwise, it may lead to pelvic inflammation.