I had Mifepristone and Misoprostol. Why is there delay in bleeding?

Hello,

Welcome to icliniq.com.

I understand your concern.

Since you took Mifepristone and then Misoprostol after 24 hours, the cramping means the body has started responding. Bleeding can sometimes take anywhere between four and 24 hours after Misoprostol.

The white and red discharge is usually the cervix opening up, so it is not a bad sign yet. You might be having an incomplete medical abortion (early stage).

The probable cause may be that the uterus is taking time to respond to the Misoprostol effect. So, I suggest you get a few investigations, such as:

1. If no bleeding even after 24 hours, do an ultrasound of the pelvis to rule out retained products or an ongoing pregnancy.

2. Urine pregnancy test after 10 to 14 days to confirm completion.

A few other causes to consider are:

1. Delayed uterine contraction response.

2. Incomplete abortion.

3. Ongoing early pregnancy.

Your treatment may include:

1. Wait for about 12 to 18 more hours. If there is still no bleeding by 24 hours after taking the first Misoprostol, you can take two additional Misoprostol tablets (200 mcg each) buccally or vaginally after consulting a gynecologist and reconfirming the need for this treatment.

2. If you experience severe pain, heavy continuous bleeding (more than two pads per hour), high fever, or foul discharge, go to the emergency room immediately.

3. Keep hydrated and rest.

4. Avoid intercourse and tampons for two weeks.

5. Use contraception once abortion is confirmed complete.

6. Do not repeat Misoprostol without confirming with a doctor if heavy pain persists.

Please follow up after 24 hours, and update whether bleeding has started or not. After that, do a pregnancy test in 10 to 14 days.

If positive or if bleeding was very light, get an ultrasound to confirm complete evacuation. Follow up with a gynecologist for further guidance on next steps.

I hope this helps.

Thank you.