Expert: Shan Yi Sheng - 8/12/2011

Question
QUESTION: My wife has shown +ve pregtest,for which she has taken,200mg Mifepristone and 400mcg vaginally and 400mcg orally after 24 hours of Mifepristone.But there was no bleeding or spotting,so she took another 800mcg orally after 24 hrs of misopristol.Now after 10 hours of misopristol she is having light bleeding(4 to 6 ml each hour).Has the medicine worked,or still working or the abortion has failed? What should we do now if this amount of bleeding continues.Should we go for another dose of misopristol or not?If yes then then in what amount,vaginally or orally.pls help.as the situation is going intense.Pls reply soon.we Badly need you help sir.

ANSWER: Dear Sam, obviously this pregnancy is unwanted.
You forgot to tell me in which week of pregnancy your wife is.
After 6-7 weeks the mifepristone works less good.
Secondly: In India there is a lot of fake mifepriston on the market.
If the pregnancy is very young, there is no much bleeding, but there always is bleeding if the mife is OK.
The miso should be taken in the cheek or under the tongue. Not swallow; no need for putting
miso in the vagina. Look at:
http://www.womenonwaves.org/set-274-en.html
Now the program:
1) have an ultrasound made to see if there is a pregnancy and how many weeks it is.
2) if your wife has a very young pregnancy controle the Mifepristone.
look at:
http://www.google.nl/search?tbm=isch&hl=nl&source=hp&biw=1440&bih=750&q=mifepris

3) if the drug is OK and the pregnancy young, take the misoprostol as described in : http://www.womenonwaves.org/set-274-en.html
there should be  some reaction.
Keep in touch,
Dr Shan



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

QUESTION: Sir she is in 2oth day of pregnancy.We might not be able to go for an ultrasound test.
She is bleeding 3 to 4 drops per hour.Is medicine working.Should we go for another dose.
Or should we wait.There is minimal but multiple instances of cramping though not unbearable.
Please guide us through.

Answer
Hi Sam again,
now that you tell me the pregnancy is very young, we still have time to wait and see what happens.
If the cramping stays, there is no need to take another dose of miso. Yet.
You must wait for some more bleeding and perhaps a clot of blood with some whitish tisue.
If there is a clot coming out put this in normal tapwater and shake until the clot is dissolved.
You easily find the whitish tissue then.
If nothing happens, mail me in three days, and we will discuss further options.
Bye for now;
Dr Shan