Complications After An Abortion?



In rare cases, some women bleed more than normal after an abortion.  The best way to tell
if you are bleeding excessively is by counting the number of pads you change each hour. Call the office f you soak more than two maxi pads in one hour for two hours, or if you pass large clots or feel dizzy and light-headed—these  are signs that you are experiencing excessive blood loss.
Uterine cramping is normal after any type of abortion.  The main way that your uterus controls bleeding is by contracting, squeezing the blood vessels shut.  Heavy bleeding can happen if your uterus relaxes too much (uterine atony), which can be treated with medication, or if some pregnancy related tissue is retained in the uterus (incomplete abortion). 
Very rarely, excessive bleeding can be from a uterine injury (perforation) that occurred during the abortion.


Severe and persistent pelvic pain is not normal after an abortion. Please contact the office if you have persistent, severe pelvic or abdominal pain after taking pain medication (acetominophen, ibuprofen, naproxen).  
The most common cause of pain after an abortion, is a bacterial infection.  Most infections are mild and can be treated with oral antibiotics.  Post procedure pain or persistent pain after a medical abortion, can be caused by retained fetal or placental tissue, or blood clots.  If the tissue or clots do not pass vaginally, you may need medication (oral misoprostol) or a vacuum aspiration (suction curettage) to empty the uterus.  This will relieve the pelvic pain.
In rare cases, pain may indicate an ectopic pregnancy, when an embryo is implanted outside the uterus, most often in a fallopian tube.  A growing ectopic pregnancy can stretch and rupture the fallopian tube, causing severe pain and heavy abdominal bleeding.  An ectopic pregnancy requires immediate medical attention (it is diagnosed by clinical symptoms, blood test results, a physical exam and a pelvic ultrasound), and is treated by medication (methotrexate injection) or by surgery.


If you have a persistent fever of 100.4 degrees Fahrenheit or above for more than two hours, you may have an infection.  Misoprostol can cause a short term fever.  However, if you have a persistent fever for several hours, or if you have severe pain, contact our office.  


Symptoms of pregnancy such as nausea, fatigue or breast tenderness usually resolve within a week or two after an abortion.  If these symptoms perist, you may still be pregnant and should visit our office for a consultation with  a pelvic sonogram.
Taking a home pregnancy test is not helpful, because you can continue to test positive for 4 to 6 weeks after an abortion, due to pregnancy hormones the are still in your body. Also, if you began using a hormone based birth control (the Pill, patch or vaginal ring) right after the abortion, be aware that these contraceptives can cause pregnancy-like symptoms, especially during the first months of use.
Dr Emily

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