Expert: Doctor Early Options - 5/4/2009

Question
QUESTION: Hi Dr.Joan,

I had unprotected sex with my girlfriend on 4th Apr and she did a pregnancy test on 27th Apr that showed +ve results. Then she had a 3 mifepristone tablets on 27th Apr and after 48 hours she took 4 misoprostol 200 tablets orally. We have been advised that she will be bleeding after 48 hours but it has been now more than 60 hrs, she didn't bleed, no cramps.
What should we do in this case? Please advice


ANSWER: Dear David,
The most likely scenario is that the abortion pills did not work - which happens about 2-3% of the time.  It may be because the second tablets were taken incorrectly (four misoprostol pills orally).  There is no problem with repeating the misoprostol. This time have her put them in her cheek, between her teeth and her gums, two on each side of her mouth, and let them dissolve them for 1/2 hour. After that, she should swallow whatever is remaining.  If this doesn't work, the misoprostol can be repeated a third time, 24 hours later.  The much less likely scenario (but of more concern) would be that she has an ectopic pregnancy.  If she had an ultrasound before she did the pills, they should have determined that the pregnancy was in the uterus.  If she did not have an ultrasound, and the second and third round of misoprostol doesn't work, she should see a doctor immediately.
I hope this is helpful,
Doctor Joan
EarlyAbortionOptions.com
New York City

---------- FOLLOW-UP ----------

QUESTION: Hi Dr.Joan,

Many thanks for the reply!

I am really confused, because after taking the misoprostol we have tested the pregnancy test 3 times two with the home pregnancy kit and the one in to a pathology lab. All test showed negative results .She is still not having any bleeding etc. Should we still use misoprostol

Please advice...  

Answer
Dear David - I am wondering whether the initial pregnancy was incorrect.  Maybe she was never pregnant.  It doesn't sound like she needs to take misoprostol, as she is not pregnant now.  I assume the test in the pathology lab was a blood test?  The blood tests are most accurate, and can give you 100% reassurance.
I hope this is helpful,
Doctor Joan
EarlyAbortionOptions.com
New York City