From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Heavy vaginal bleeding three weeks after a medical abortion requires immediate medical attention, and the most recent evidence suggests that a conservative management approach with misoprostol may be the most effective treatment option. According to the study by 1, primary surgical management should only be prioritized in hemodynamically unstable or septic patients, and conservative management can be successful in avoiding surgery in a significant number of patients. The study by 2 also found that expectant management was successful in almost 80% of patients with retained products of conception following abortion.
Key Considerations
- The patient should contact their healthcare provider or go to the emergency room if they are experiencing heavy bleeding, severe pain, dizziness, or fever.
- An ultrasound should be performed to assess the situation and determine the best course of treatment.
- Treatment options may include misoprostol (800 mcg vaginally or sublingually) to help expel remaining tissue, antibiotics if infection is present, or a surgical procedure like vacuum aspiration to remove retained tissue.
- The patient should stay hydrated, monitor their temperature, and keep track of how many pads they are using to report to their healthcare provider.
Treatment Options
- Misoprostol: a medication that can help expel remaining tissue and reduce bleeding.
- Antibiotics: may be prescribed if infection is present.
- Vacuum aspiration: a surgical procedure to remove retained tissue.
- Expectant management: a conservative approach that allows the body to expel the retained tissue on its own.
Important Findings
- The study by 3 found that misoprostol is most effective in the setting of retained products of conception if the primary treatment for miscarriage was expectant management.
- The study by 4 found that uterine artery embolization can be a successful treatment option for retained products of conception with marked vascularity.
- The study by 1 found that primary surgical management should only be prioritized in hemodynamically unstable or septic patients, and conservative management can be successful in avoiding surgery in a significant number of patients.