Expert: Shan Yi Sheng - 2/21/2010

Question
QUESTION: i recently had a medical abortion, i passed clots but i didn't bled much.  I had brownish spottings for several weeks.  havent had my period after 8 wks so i had transvaginal ultrasound.much to my surprise the baby survived! it was 14 weeks & 5 days but also there was a myoma uteri seen.  I want to repeat the medical abortion since i recently also had an xray done and i know that the procedures i went through might have affected the baby and may cause much damage in the future.  in my country, medical abortion is a crime.but there are those who are willing to help in private.  My question is, can the baby abort successfully using abortion pills through vaginal insertion,and how long does it becomes visible during transvi ultrasound.  I cannot opt for surgical abortion since i have myoma right now...please help

ANSWER: Dear Lady,
in about 4 % medical abortion with pills does not work.
This is one of the reasons I do never recommend the "pill-abortion"
At your stage of pregnancy a D&C is the method of choice.
If you find a good doctor the myoma is not a big problem for the D&C.
Pills at 15 weeks may cause heavy bloodloss.
I hope that you live in a country where D&C  available.
This fetus can be severely harmed by the pills you took, so abortion is the
only solution.
Succes !
Dr Shan
.

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

QUESTION: that's my problem right now,only midwives could do that for me but when i asked her she told me she cannot perform it due to my myoma..can a doctor tell if the fetus is healthy by just looking into the ultrasound?i know the fetus is already harmed since i have been experiencing cramps every now and then most especially when i am stressed and tired... and also I just had an xray exam thinking i wasn't pregnant anymore..if i opt to medical abortion, and if somehow there's too much bleeding, if i go to the hospital could they tell that i had an abortion?how long does the pills visible in the system? please help me..

Answer
Hi there,
a doctor can teel you if the ferus is OK at twenty weeks.
Asafe way to do the medical abortion is to go to the hospital and take the pills   800 mg (so 4 pills) in your cheek.
Do not swallow and let them melt there. No bad taste.
If you sit in the waitingroom you are safe. If there is much bloodloss coming, you can immediately alarm the staf and tell them you had cramps.
Do not tell about the pils !
Good luck,
Dr Shan