Expert: Shan Yi Sheng - 9/29/2010

Question
Hello
On Sept 18 I went to the doctor for a pregnancy test
and non-surgical abortion. I had an ultrasound with a
6 week old fetus. I was given methotrexate orally
because of my fear of needles. Then I was given 8
200mg pills to insert in the vagina 5-8 days after. I was
also given prescription for tylenol with codine.  I
followed the direction 6 days  after. inserted4 pills at
night before sleeping as told by doctor. I felt mild
cramping and soon fell asleep. I woke up with
absolutely no bleeding or any discharge. the next night
I inserted 4 pills and went to sleep. I woke up with no
discharge. the next morning I had some clear
discharge mixed with very very light fresh blood. I was
expecting that I would be bleeding heavily throughout
the day but no more blood but brown spotting. And
since Sept 26 til today I am just getting brown
spotting/discharge .  Still no heavy bleeding after 4
days of pill insertion. If I didn't have any blood or
brown spotting I would be convinced that the pills
failed. But right now I am very confused on whether it
worked or not. Please help. Thank you.

Answer
Hi Liz,
Normally MTX is used for abortion less than six weeks:Risks

Vaginal bleeding during the miscarriage caused by MTX may be heavy. In rare situations it could require a surgical abortion and very rarely, a blood transfusion.

Studies show MTX abortion has a failure rate of 1-10%.

The doc can see from your B-HCG blood level if the abortion is succesful.
Why not go back to him/her ?
You'd better do that, and ask him; I am 8000 miles away and cannot see clearly what happens to you.
By for now,

Dr Shan