QuestionQUESTION: Dear doctor,
I was diagnosed with missed abortion and opted for a medical treatment with Misoprostol. I took 400mg vaginally (as prescribed by my doctor) and had some cramping and a period like bleeding afterward. I passed 2 large tissues that looked like a thick membrane and a gestational sack. I had a FU U/S today and was told that I retained some small tissue in my fundus. The doctor recommended a D/C or wait till the next period. She also gave me 800mg of Misoprostol if I decided to repeat the treatment to try and pass the tissue. I am afraid to wait as I am scared of infection due to retained fetal tissue.
What would be the safest method of management of my situation?
I appreciate your prompt response.
ANSWER: Hi Inna :)
Whatever you choose is safe. So it's not about what's safest, but about what's preferable to you. If you're not comfortable waiting, then by all means, you do not have to, and you should feel perfectly safe taking the Misoprostol again. You can also go with the D/C, a very safe procedure if you feel best doing that. For your sake, it seems like getting rid of the tissue once and for all is best, because you shouldn't have to spend time worrying.
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QUESTION: Dear Danielle,
Thank you very much for your response,
What are the chances that the tissue will get out during the first period that I get? How does it work? Does it come out with the uterus lining?
ANSWER: There's not an exact number or percentage I have to give you that would indicate exactly what your chances are, but they are very high, and almost 100% (only because few things are ever really 100%). You're exactly right-your uterus lining will shed like it always does during your period, and within that lining will be the remaining tissue. During many surgical abortions, doctors will leave in tissue that the body will get out on its own. I'm sure the doctor will want to check after your period to make sure it's all gone, and it most likely will be. :)
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QUESTION: Dear Danielle,
I had a follow up U/S last Friday that confirmed the retained tissue. I was prescribed another dose of Misorpostol 600 mcg vaginally and 400 mcg the following morning vaginally. I took all these last Friday and Saturday. I was cramping for almost 14 hours after the first dose. I did not have any bleeding, just a little brown spotting. After the second dose I did not even have any cramping. Today is monday and there ios nothing happening. What could be the reason that I did not have any bleeding?
AnswerSounds like the medication didn't work. You really should have started to bleed more by now, and maybe your body is just not reacting to the medication. You may need to get a surgical abortion done, or a D&C to get rid of that last tissue. Could you call and ask them why you haven't bled more? Or make another appointment, and go for a different procedure.
