With the abortion pill becoming the most common abortion method, it is important to familiarize yourself with potential side effects and risk factors associated with this regimen.

If you have taken the abortion pill regimen of mifepristone and misoprostol, an uncommon complication that can happen is an incomplete abortion.

What exactly is this condition?

An incomplete abortion is when some of the pregnancy tissue remains inside your uterus. A pregnancy test may still be positive but that does not mean the pregnancy is viable.

An incomplete abortion can occur after a miscarriage if not all of the pregnancy tissue is removed. An incomplete abortion can also occur after an abortion if pregnancy tissue still remains after taking the abortion pill. Medical intervention is usually required if an incomplete abortion is suspected.

What are the symptoms of incomplete abortion?

After a diagnosed miscarriage or taking the abortion pill, bleeding and cramping are normal as you pass the pregnancy.  Typically, the bleeding increases until you see clots and pregnancy tissue. The bleeding lasts for a few hours and then decreases in amount and can last for a few days.

 

 

Seek medical attention if, after passing the pregnancy tissue, you notice the following:

 

  • An Increase in heavy vaginal bleeding (soaking more than two pads an hour for two hours)
  • Lower abdominal pain that radiates through the lower back and pelvic region
  • Cramping

How is incomplete abortion treated?

According to the American College of Obstetricians and Gynecologists (ACOG), the most common treatment for incomplete abortion is to repeat a dose of misoprostol. Depending on doctor recommendations and patient request, other methods such as uterine aspiration or expectant management may be considered instead. [2] 

Let’s break these down in more detail.

  • Repeat dose of misoprostol
  •   According to Guttmacher Institute, treatment of incomplete abortion using a repeated dose of misoprostol is 99% effective at emptying the uterus if the pregnancy is 12 or fewer weeks. [3]
  • Uterine aspiration
  •   Uterine aspiration (also called suction or vacuum aspiration) is a medical procedure in which the cervix is dilated (opened) and a suction device is used to empty the uterus. [4]
  • Expectant management
  •   This involves waiting and allowing the uterus to empty its contents spontaneously. This method is not typically recommended due to low efficacy (lower success rates) and the timeline for such events to occur is unpredictable. [5]

How common is this condition?

According to research, treatment failure of medical abortion using mifepristone and misoprostol occurs approximately 4.8% of the time and requires hospitalization at a rate of 0.3%. [6]

If you’ve taken the abortion pill regimen of mifepristone and misoprostol and are experiencing troublesome symptoms, go to your nearest emergency room as soon as possible. Incomplete abortion requires medical attention.

At LifeSpring we offer post-abortion support. If you have had an abortion and want to talk through any concerns or need help processing your experience, schedule an appointment to come see us.

Our trained, compassionate staff will offer you information, resources, and support with no judgment and at no cost. You are not alone.

 

Sources:

[1] https://www.ncbi.nlm.nih.gov/books/NBK559071/

[2] Medication Abortion Up to 70 Days of Gestation | ACOG

[3] https://www.guttmacher.org/journals/ipsrh/2014/12/use-misoprostol-treat-incomplete-abortion-should-be-limited-first-12-weeks

[4] https://www.acog.org/womens-health/faqs/induced-abortion 

[5] clinguide_pacguide_en.pdf (gynuity.org)

[6] https://pubmed.ncbi.nlm.nih.gov/22898359/