Expert: Doctor Early Options - 5/27/2011

Question
QUESTION: I was about 5-6 weeks pregnant and I had a medical abortion. I was given a shot and some cycotec to insert over a period of hours. Nothing happend right away, but the next day there was heavy bleeding and I bleed for the next three days and then...nothing...no more bleeding? No discharge...nothing. This was excatly a week ago.

I was worried about whether or not the abortion was complete, so I did an ultrasound....there is no heart beat dectected, but the technician discovered a small mass in my womb...should I go in for a suction prcedure or wait and see if I will pass out what ever it is by a certain time? Is it possible that it can go away on it's own? The suction procedures are very expensive, so I am wondering if I should wait as I have no pain, or indication of an infection?

Your respnse would be greatly appreciated. Thanks in advance.

ANSWER: You need to repeat the Cytotec.  We usually have our patients take 4 tablet and place 2 on each side of the mouth between the cheek and the gums or you can place 4 tablets inside the vagina.  The mass is probably a blood clot that you need to pass.  This would help prevent you having a suction procedure.  You probably will not pass it if you have not passed it by this time.  

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

QUESTION: Is there a limit to just how many cytoec one can take over a period of time?

As I said I was given a shot and then told to take 12 tablets inserted in the vagina(2 every two hours). This was on the 14th of May and all I got was the three days bleeding afterward. I am wondering if taking any more would cause any lasting problems? How long does these tablets remain in your system?

I am just so worried about doig any permanent damage.

Thank you kindly for your speedy reply and your advice.

Your Repestfully
Nicky

Answer
Sometimes the Cytotec may not be effective.  The vaginal method can some times not be effective as you just describe.  So it seems that if you did 12 tablets, then you are what we consider a treatment failure.  The shot you had was Methotrexate which is not as effective as Mifepristone.  If you do the 4 tablets vaginally and you do not pass the pregnancy then you will need an aspiration procedure.  The cytotec does not cause any long term damage.