Brief Answer:
Ultrasound needed for confirmation

Detailed Answer:
Hello and welcome,

I am not sure why you used the cytotec. It seems that it was used to induce an abortion as that is the commonest indication.

I will answer the query assuming that you used it to induce abortion. If this is not the reason why you used it, kindly clarify the reason and I will modify my answer accordingly.

For inducing an abortion, cytotec is not the drug of choice. It is used with mifepristone as otherwise most of the time the procedure remains incomplete if cytotec is used alone. The only way to confirm the completeness of abortion is by a vaginal examination by a gynecologist and a follow up ultrasound.

The success depends upon how big the pregnancy. A heavy bleeding suggests that most of the products were expelled, but presence of brown discharge for so long indicates that there may be some bits inside. So I advise that you kindly get an ultrasound done for confirmation.

Kindly inform me if you used it for any other reason.

Hope this satisfies your query.
Thanks for using HCM.     
Feel free to ask any more questions that you may have.
Dr Madhuri Bagde
Consultant Obstetrician and Gynecologist

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Brief Answer:
Detailed answer below.

Detailed Answer:
Hello and welcome back,

So you used it for an abortion. I have already said that it is not to be used alone as it causes incomplete abortion in many cases.

You used cytotec for the first time 3 weeks ago and then repeated it 2 weeks ago and 1 weeks ago the pregnancy test was still positive. A pregnancy test usually comes negative about 2-7 days after the procedure. If it is still positive then chances of an incomplete abortion are higher.

By PRODUCTS I mean retained bits of tissue from the pregnancy. So when I say most products were expelled I mean that most of the tissue from the pregnancy was expelled. But the presence of brown discharge indicates that some bits may be retained and unfortunately the only way to know this is by an ultrasound scan. I understand your problem, but as a gynecologist it would be unfair if I give you incorrect advice.

Please get an ultrasound done if possible to confirm that no tissue is left inside.

It is not okay to repeat the procedure at all as the procedure itself is not an approved process for inducing an abortion. I have already said that 2 drugs mifepristone and misoprostol are used and only after an examination by a gynecologist and confirmation about the location and duration of pregnancy.

I hope this answers your query.

Take care and I understand your predicament very well.

Dr Madhuri

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Brief Answer:
Not every woman will fall sick.

Detailed Answer:
Welcome back,

In some cases the retained tissue may get infected and in that case there will be foul smelling discharge, there may be fever and the patient feels sick. But this happens only if there is an infection. We cannot predict who will get infected and who will not and also never take any risks in that direction. So if any retained bits are found in ultrasound we do an evacuation or a dilatation and curettage procedure so that the source of infection is removed.

So not every woman with an incomplete abortion will fall sick though she is slightly at a higher risk of falling sick. My only worry is the discharge that must not be there until now. It usually clears in 48 hours to 7 days at the most.

Hope this was helpful.
Take care.
Dr Madhuri

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