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Forum Name: Obstetrics

Question: Cytotec removed foetus but left gestational sac


 Kanyine - Sun Feb 28, 2010 2:02 pm

Dear Dr,

I used cytotec 2 weeks ago to remove a pregnancy that an ultrasound had shown to be 7 wks + - 1 wks. 4 hours after I used it I experienced heavy bleeding (clots) for 4 hours. I have been spotting on and off for over a week now (brownish).

I did another ultrasound today and it says I have a “slightly bulky retroflexed uterus...there is a collapsed gestational sac without demonstrable fetal echo. The myometrium is uniform. No fibroids, cysts, masses, pelvic fluid collections. Conclusions- Incomplete abortion”.

I live in a third world country and I was worried about the safety of doing a D&C and thought this was safer and better. What are my options now that it has not worked? Should I wait for the sac to come out & for how long? I am really worried.
 Debbie Miller, RN - Tue Mar 02, 2010 6:54 pm

User avatar Hello,
In most cases the body will naturally deal with this through reabsoption. Watchful waiting is an approach to a medical problem in which time is allowed to pass before medical intervention or therapy is used. Most of these cases (65–80%) will pass naturally within two to six weeks. Medical management usually consists of using misoprostol so perhaps a repeat of Cytotec could be used but you should discuss this option with your health care provider. This is used in cases of spontaneous "missed abortion" to complete the process and In those cases most will complete within a few days.

A D&C is commonly performed to reduce risk of bleeding and infection if some tissue remains inside, but if your health care is not good there, perhaps the procedure would carry more risk and watchful waiting may be your best plan. If you have heavy bleeding, fever, chills or other signs of infection, see your doctor right away.

Best wishes.
 Kanyine - Fri Mar 05, 2010 1:44 am

Dear DR,

Thank you very much for taking the time to respond. The work you guys are doing here is wonderful. I will go for watchful waiting and give an update so that perhaps someone else will learn from the shared experience. Really grateful.

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