QuestionQUESTION: I am from Italy and I had an anembryonic gestation discovered at the 7th week, but the gestational sac (18 millimeters) didn't exit my uterus. Unfortunately in Italy there is no medical tratment but only D&C. Since I was scared of surgical procedure, I went to Switzerland to make the medical abortion with Mifegyne and Cytotec. I immediately expelled the gestational sac, but now after 10 days from the treatment I still have residual tissue inside my uterus and I have no pain and I don't loose so much blood anymore. From an ultrasound scan results that I have a piece of residual (blood or trophoblast) 16 x 4 millimeters.
In Italy the doctors want to make the D&C because of the risk of infection. Instead, in Switzerland the doctor tols me that I should be able to expell those residuals with the next period. I would prefer this way because I'm so scared about D&C.
My questions are: is it safe to wait with a residual of the dimension of 16 x 4 mm or I can risk infections? Will my body be able to have the period also if there are still residuals in the uterus, even in case it is trophoblast? In this case, can my body expel the residuals with the next period?
Thanks so much in advance.
Kind regards,
Laura
ANSWER: Yes, it is safe to just wait. You can even have a second dose of Cytotec which will help the uterus expel the residual lining. We rarely do any intervention unless it has been longer tha 4 weeks or the patient is having heavy bleeding or severe cramping.
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QUESTION: Thanks for your reply.
My first dose of Cytotec consisted in 2 tablets taken orally. You mean that now I could take other 2 Cytotec tablets orally, after asking to my doctor?
From your answer I understand that it is safe to wait for 4 weeks. After that period of time do you think I should get D&C if I don't expel all the residuals? Or could I wait for even longer period of time if I feel well (without fever and without cramping nor bleeding)? I'm a bit concerned because I've stopped bleeding, so maybe I will not able to expel the residuals in 2 more weeks. Is it possible that I will expel them with my next period, or that my body will absorb them somehow?
AnswerYou can take 2 tablets of Cytotec under your tongue for 2-3 doses. It can take 4 weeks to expel everything. Most women bleed 4-6 weeks after the medication abortion. You only need a D&C if you have heavy bleeding, severe cramping or a fever. We do the manual vacuum aspiration and not the D&C. Before we decide to intervene, we do an ultrasound, So, not having lppkedd at your ultrasound, I can not give a definite answer. However, we never do a D&C.
