Expert: Shan Yi Sheng - 8/19/2011

Question
QUESTION: Hi.
My last period was 6/29/2011 my period for july didnt came so i took a pregnancy home test 7/27,
it came out positive. I took misoprostol 8/17 i think i was 4 to 5 weeks pregnant then if my calculation were right.
I took first dose of misoprostol bucally at midnight, no cramps and no bleeding, then took the second dose after 3 hrs again but with less cramps and no blood, i took the 3rd dose again after 3 hrs and my cramps started but not too intense that i was able to sleep normally. When i woke up next morning my bleeding started but not too much , i saw a dark little blood clot maybe 1 1/2 inch size then just a little heavier than usual bleeding. Later that day
a bigger clot came out about 3 inchez very dark, grayish blood clot then after that just a heavier than usual bleeding. I think in 24 hrs since i started the misoprostol i just used 3 to 4 big pads. Then the next day my bleeding was normal just like a normal menstration , it lasted for a day then just dark spotting for a couple of days. Its more than a week now after my abortion and im still having small cramps sometimes but not painful, and im still having some after menstration spots.
Ive been doing research about incomplete abortion fearing i might had one but i read that if its an incomplete abortion i will still bleed a lot after accompanied with fever and such, but i had none of those.But maybe it depends on the person.
Do you think my abortion was successful??
I read i had to wait 3 weeks after i take a preg test again, im so anxious and nervous that im thinking of going to see my doctor soon.
Your help will be greatly appreciated.

Follow up question:
I just got back from my doctor and had an ultra sound, the doctor said im still 6 weeks pregnant:(
I asked if theres gonna be a defect coz i had the medicine and bled and she said for now the baby is just 5.8 mm and she said for now its healthy but she wants me to come back after 2 weeks to see if the baby is growing.
I dont think shes sure if the baby is ok:( im scared now that the baby may have defects.
My question is can i still take misoprostol to complete my abortion? Im scared to take it vaginally but im thinking it wont take effect again if i dont use it orally and vaginally. If i do take it again how many times do you think i should take it?? And i just found out my misoprostol is about to expire , could i still use it?? Should i take the meds while im still on my 6 weeks? or should i wait after 2 weeks till my doctor can tell if the baby is growing? And ive been having terrible migraine lately so im taking pain meds, will that effect the baby too?and im having light fever since yesterday too. I dont think i got the right answers from my doctor coz it seems she cant tell if the fetus inside me is alive. She just said its healthy and i should come back in 2 weeks to see if its growing or not:(
Im really so confused right now:( i dont want to wait till im more than 6 or 7 weeks just to find out i had to do a surgical abortion which i really would not want to do:(
Pls help!
My fiance is leaving for deployment in a week and i dont want to do this alone but i feel like i have to finish what ive started especially now that i had took the abortion pills already.
Please help."

ANSWER: Hi dear Kimiko,
I am not in favor of medical abortion at all. You see yourself that you can loose blood and clots and still be pregnant.
The best is a surgical abortion. A suctioncurettage takes three minutes and you can be sure its over then.

Your other questions:
Yes, when the fetus is very young drugs may cause defects.
At six weeks it is not yet possible to see if the fetus is alive by US.
At 8 or 10 weeks one can see heartaction.
Did you take the misoprostol the right way ? Buccaly the way as described by "women on waves ?
http://www.womenonwaves.org/
Anyway, let me know what you want.
bye for now,
D Shan


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

QUESTION: Thank u for ur reply.

Yes bucally/orally like what the womenonwaves said. I had a medical abortion before in a hospital with my doctor for 6 years to assist me and it was successful but right now that i moved into a different city my doctor is too far away so i went to womenonwaves for help how to do it.
I wasnt satisfied with my new doctors test on me:( i told her that i bled ( with clots, diarhea, cramps) and that im still having a brown discharge till now but not heavy. I asked her why im having a light fever and headache, i asked her if there is a chance that the fetus is already affected and she did an ultra sound and just told me that the we have a fetus its this size, it looks healthy and that i should come back in 2 weeks so i can find out if its growing. I even asked to have a cancer test just in case and she didnt do it:( and later i found out from a nurse that you can have a that test even when your pregnant:(
I left the hospital confused and questions not answered:(  
I still have plenty of misoprostol left and im thinking of trying again. Honestly im scared to use it vaginally just in case something goes wrong i can always run to my doctor and they wont see the medicines. But i really want to try again and i dont want to wait till the fetus is over 9 weeks coz i know by then i know my only choice is medical abortion and here the bigger the fetus the more expensive you pay coz abortion is legal but is not covered by our medical insurance.
I read on some that has similar case llike me but they didnt take an US , they did the medication again and it worked. Thats why i want to try again. If i will, should i do the procedure the same as bfore? Or should i really do it vaginally and orally?

Answer
Ok, dear Kimiko,
You may try again with the miso. Buccally is more sure than vaginaly, as the mucus in the vagina is a barrier for the drug.
Just take two tabs in your cheek and spit out after one hour. One hour later take two again...same system until u used 10 tabs.
Thats the best way in your situation. Do not swallow the pills. They may cause stomach cramps and  diarhea. Some time also a bit fever,
but never very high.
I told you I have seen many many problems with the pill abortion. Takes hours, and afterwards weeks of doubt if it was successful.
I would strongly recommend  suction curettage. I did thousands of them. Without problem...its about the safest operation there is, and the most performed in the world. but OK..... its your life ad your choice.
Good luck.

Dr Shan