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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Had Missed Abortion, Did Evacuation. Bled A Lot. So Stopped. Tried Misoprostol, Didn't Work. Have Subserosal Fibroid. Treatment?

I had an Evacuation for Missed Abortion of 12 wks on 14th may, I bled almost a litre and my Doctor had to stop the procedure as there were no fetal parts coming in the suction and only blood. After Evacuation , USG showed retained products. Medically tried with Misoprostol tablets but didnot work. Is there any other any other option? My last USG on 21st showed RPOC of 18mm.I have a subserosal fibroid of 13cm, my doctor advices Hysterectomy. I still feel nausea, why is that so?
Thu, 30 May 2013
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General & Family Physician,  's  Response
Hello,
thanks for using health care magic.

Hysterectomy is rather aggressive and i doubt if its actually what you want. If you are interested in having children then hysterectomy is not the best option.

At 12 weeks of gestation, suction is not the better option. Use of a sponge forceps and curettage after induction with misoprostol would have been the best option to take.

What you should do now is to meet a gynecologist for a better and appropriate curretage to be done after which you will be given misoprostol intra rectal to help contract the uterus and prevent bleeding.

Concerning the fibroid issue, 13cm is quite big but subserous fibroid has little or no effect on the contraction of uterine muscles unless it grows into the wall. However, you could rather go for a myomectomy and not hysterectomy which is rather aggressive at moment.

Best regards and hope this helps you
Dr Achuo
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Had Missed Abortion, Did Evacuation. Bled A Lot. So Stopped. Tried Misoprostol, Didn't Work. Have Subserosal Fibroid. Treatment?

Hello, thanks for using health care magic. Hysterectomy is rather aggressive and i doubt if its actually what you want. If you are interested in having children then hysterectomy is not the best option. At 12 weeks of gestation, suction is not the better option. Use of a sponge forceps and curettage after induction with misoprostol would have been the best option to take. What you should do now is to meet a gynecologist for a better and appropriate curretage to be done after which you will be given misoprostol intra rectal to help contract the uterus and prevent bleeding. Concerning the fibroid issue, 13cm is quite big but subserous fibroid has little or no effect on the contraction of uterine muscles unless it grows into the wall. However, you could rather go for a myomectomy and not hysterectomy which is rather aggressive at moment. Best regards and hope this helps you Dr Achuo