Any woman is familiar with such a phenomenon in the body as menstrual cycles. Bloody discharge appears monthly for 5 to 7 days. In reality, the duration of menstruation varies for each girl, everything is individual. In fact, the presence of menstruation in the female body indicates the woman’s readiness to bear a fetus, that is, to give birth to children.
In case of abortion, the nature and intensity of bleeding may change. Abortion is the premature termination of pregnancy by artificial means. Such external interference in the female body can cause heavy bleeding. By contacting us for help, you can count on:
- the work of highly professional and experienced specialists;
- use of modern and safe techniques;
- minimum trauma to the body;
- minimizing the development of complications;
- compliance with all regulations and sanitary and hygienic standards;
- attentive and careful approach to each patient;
- keeping all customer data confidential.
It is believed that the first menstruation occurs 20-50 days after a medical abortion. It is worth noting that the body of each representative of the fair sex is strictly individual, and not everything always coincides with the established deadlines.
With a medical abortion, periods usually coincide with the usual cycle. With the vacuum method, the onset of menstruation is noted after 30-50 days, and with the instrumental method - after 30-45 days.
If you experience a long delay of more than 40 days, you should seek examination and advice from an experienced doctor. This will allow timely detection of possible complications and prevent the development of various diseases.
A longer delay in menstruation may indicate amenorrhea. It is often understood as the absence of menstruation for some time, from six months or more.
True amenorrhea is characterized by reduced functioning of the ovaries, since sex hormones are not enough for normal cyclic changes in the mucous membrane of the uterine body.
False amenorrhea is characterized by the standard functioning of the endometrial functions, with the exception of the absence of blood discharge from the vagina. This is often observed in children, adolescents and women during menopause.
In most cases, postpartum amenorrhea occurs during the breastfeeding stage, and on average lasts several years.
By the way, the absence of menstruation is not a disease at all, but a symptom associated with serious disorders in a woman’s body. For safety and reproductive health reasons, in such situations it is worth contacting a gynecologist.
Features of bleeding after an abortion
Bleeding may be completely absent during the first two days after surgical termination of pregnancy, but later it intensifies to menstrual bleeding and continues in some clinical pictures for up to 6 weeks. This pathology indicates a hormonal imbalance, that is, there is insufficient “support” of endometrial tissue, which supports the development of pregnancy. As a result, bleeding after termination of pregnancy can only intensify and continue intermittently for several weeks. It is important to understand that here we are talking about pathology.
Most women of reproductive age are concerned about the main question: how long will bleeding last after an abortion? The question is individual, but if it does not go away for more than two weeks after getting rid of the fetus, it is important to urgently contact your local gynecologist. The duration of hemorrhage also depends on the duration of pregnancy: the earlier an abortion is performed, the greater the chances of solving such a piquant problem in a gentle “mode” and without serious consequences.
Incipient miscarriage
Spontaneous miscarriage
A miscarriage, or abortion, is the termination of pregnancy during the first 28 weeks.
Depending on the period when the termination of pregnancy occurred, miscarriages are divided into early and late. Early miscarriages include abortions before 14 weeks, late miscarriages - from 14 to 28 weeks of pregnancy. Termination of pregnancy can be performed artificially (abortus artificialis), or it can also occur spontaneously, regardless of the woman’s wishes. Such a miscarriage is called spontaneous miscarriage, or abortion (abortus spontaneus). If a woman has repeated spontaneous miscarriages, these are habitual miscarriages (abortus spontaneus habitualis). Before examining the various causes of spontaneous abortion, it is necessary to remember what processes occurring in a woman’s body precede the onset of pregnancy and thanks to what changes pregnancy and normal intrauterine development of the fetus are possible. Pregnancy can only occur in a woman who has a normal two-phase menstrual cycle. The duration of the menstrual cycle for most women is 28 days. In the first half of the cycle, i.e. in the first 14 days, the follicle grows and matures in the ovary. As a result of this complex process, a mature egg is located in the follicle, ready for fertilization. During this so-called follicular phase, estrogenic hormones are formed in the ovary, which enter the blood and cause cell proliferation and gland growth in the uterine mucosa, i.e., a process of proliferation is observed in the endometrium. Therefore, the first half of the menstrual cycle is called the proliferation phase. Once the developing follicle reaches the maturity stage, ovulation occurs. Ovulation is the process of rupture of the membrane of a large follicle and the release of a mature egg.
At the site of the ruptured follicle, a new endocrine gland, the corpus luteum, which is very important for subsequent pregnancy, is formed from the cells of the granular membrane lining the cavity of the follicle. The hormone of the corpus luteum - progesterone - causes complex changes in the uterine mucosa, due to which the functional layer of the endometrium prepares to receive a fertilized egg. The second half, or phase of the uterine menstrual cycle, is called the secretory phase.
When pregnancy occurs, the corpus luteum continues to develop, and the release of progesterone increases. This leads to pregnancy-specific changes in the stroma of the functional layer of the endometrium, called the decidual reaction. Therefore, for pregnancy to occur, it is necessary that ovulation occurs in the ovary, and secretory and decidual transformations of the mucous membrane occur in the uterus. The influence of the corpus luteum hormone on the uterus is not limited only to changes occurring in the endometrium, the degree of which is directly dependent on the amount of the hormone produced by the ovary. Progesterone, in addition, reduces the excitability of the uterus, reduces the lumen of the cervical canal and thereby promotes the normal development of pregnancy.
There are many reasons leading to spontaneous abortion. One of the most common factors is underdevelopment of the genital organs. In this condition, called infantilism, functional inferiority of the ovary may be observed, manifested in insufficient formation of estrogen, insufficiency of the corpus luteum, as well as underdevelopment of the uterus.
In the presence of sexual infantilism, the cause of spontaneous miscarriage may be increased excitability of the uterus and insufficiency of decidual transformation of the endometrial stroma, and as a result, the occurrence of unfavorable conditions for the development of the fertilized egg.
The next, often occurring, cause of spontaneous abortion is past inflammatory diseases of the uterus (endomyometritis) and traumatic injuries to various parts of the uterus, which can result in dystrophic or cicatricial changes in the mucous and muscular membranes of the uterus.
Acute infectious diseases accompanied by high fever and intoxication, as well as chronic infections, can often lead to abortion. Malaria, infectious hepatitis, toxoplasmosis, and syphilis especially often lead to termination of pregnancy. In addition, pregnancy can spontaneously terminate if a pregnant woman is poisoned with mercury, lead, carbon monoxide, alcohol and other substances. Currently, great importance in the etiology of spontaneous abortion is given to the pathology of the blood coagulation system. Antiphospholipid syndrome and genetic thrombophilia lead to thrombosis of the chorionic vessels and subsequent detachment. In most cases, spontaneous abortion begins with detachment of the fertilized egg from the uterine wall in a small area. In this case, the integrity of the blood vessels of the decidua is disrupted. The spilled blood saturates the membranes of the fertilized egg. The onset of abruption is usually accompanied by contractions of the uterus, which, in turn, lead to the progression of abruption and the death of the fertilized egg. As a result of cramping contractions of the uterine muscles, the cervical canal opens and the fertilized egg is expelled from the uterine cavity.
Each abortion is accompanied by bleeding, the intensity of which depends on the duration of pregnancy, as well as on the rate of detachment and expulsion of the fertilized egg. With an early miscarriage, bleeding is always more profuse than with a late abortion. This is explained by the fact that in the early stages of pregnancy the entire surface of the fertilized egg is covered with a fleecy membrane. The villi are very delicate, some of them are separated from the wall of the uterus, and the other part is easily torn off and remains attached to the wall of the uterus, preventing the uterus from contracting and stopping bleeding. Therefore, detachment of any part of the ovum is accompanied by bleeding, which stops only after all remnants of the ovum are removed from the uterine cavity.
As pregnancy progresses, in parallel with the growth of trophoblast villi in the area of the future placenta, the entire remaining surface of the fetal egg is gradually freed from villi, so late-term miscarriages proceed according to the type of labor, i.e., first the cervix dilates, then the waters break, the fetus is expelled, and then the afterbirth separates and is born. As in childbirth, bleeding during a late miscarriage occurs at the moment of separation and birth of the placenta.
During a spontaneous miscarriage, several stages can be distinguished, the diagnosis of which is very important for providing correct and timely assistance to a pregnant woman (Fig. 1). In the first stage, called threatened miscarriage (abortus imminens), the connection of the fertilized egg with the wall of the uterus is disrupted in a small area. A pregnant woman notices slight nagging pain in the lower abdomen. With a late-term miscarriage, the pain is cramping in nature. As a rule, there is no bleeding; sometimes there may be scanty bleeding. A two-manual vaginal examination reveals a closed external os, a cervix of normal length, and the size of the uterine body corresponds to the gestational age. The uterus is very easily excitable.
Stages of miscarriage.
a - threatened miscarriage; b - beginning miscarriage; 1 - uterine body, 2 - cervix, 3 - fertilized egg, 4 - hematoma
The next stage of the process - the onset of miscarriage (abortus incipiens) - differs from the previous one in a more pronounced clinical picture, due to the progressive detachment of the fertilized egg, which, with its larger surface, is still connected to the uterine wall. If the therapy applied at this stage of the process turns out to be effective and further detachment of the ovum stops, then the normal development of the embryo can continue. When an abortion begins, the pregnant woman feels mild cramping pain, accompanied by small amounts of bloody discharge. The external uterine os, as a rule, is slightly open, the cervical canal can be passable for one finger.
Both in case of threatened and incipient miscarriage, treatment should be aimed at reducing the excitability of the uterus and stopping further detachment of the ovum. The pregnant woman must be hospitalized.
If the therapy is unsuccessful or in the absence of treatment, the miscarriage that has begun moves into the next stage of the process - abortion in progress (abortus progrediens), in which the exfoliated fertilized egg is expelled from the uterine cavity (Fig. 5). At the same time, the woman’s cramping pain intensifies and bleeding increases. With a spontaneous miscarriage during the early stages, the bleeding can be very strong, quickly leading the woman to severe anemia. A vaginal examination helps to easily establish the correct diagnosis. In this case, an open external os is detected, the cervix is increased in volume due to the fertilized egg located in the cervical canal, the lower pole of which may even protrude into the vagina. Abortion treatment usually involves removing the fertilized egg followed by curettage of the uterine cavity.
Abortion is in progress.
1 - body of the uterus, 2 - cervix, 3 - fertilized egg, 4 - hematoma.
Incomplete miscarriage.
a - all the membranes are in the uterus; b - remains of the fertilized egg in the uterus.
When there is a late miscarriage, there is usually no heavy bleeding. Therefore, in late pregnancy, it is advisable to wait for the spontaneous birth of the fetus and placenta, and then perform a digital or instrumental examination of the uterus.
With a spontaneous miscarriage, especially early, the fertilized egg is rarely completely separated from the walls of the uterus. Typically, part of the fertilized egg exfoliates and is born, and part remains in the uterine cavity (Fig. 6). Such an incomplete miscarriage is accompanied by heavy bleeding with clots. If a small part of the villous membrane is retained in the uterine cavity, then the bleeding may not be very intense, but prolonged. Remains of the fertilized egg in the uterine cavity can cause not only bleeding, which threatens the health and sometimes the life of a woman, but also a serious infectious disease. Therefore, diagnosis of incomplete miscarriage should be timely. The diagnosis of incomplete abortion is established on the basis of subjective and objective data. When collecting a woman’s medical history, it is necessary to find out the date of the last normal menstruation, the duration of amenorrhea, when and why the bleeding appeared, and when the miscarriage occurred. A vaginal examination reveals an open cervical canal, which freely allows a finger to pass through the internal os. The size of the uterus does not correspond to the period of pregnancy; its size is smaller, since part of the fertilized egg has already been born. The consistency of the uterus is soft.
Having examined the patient and established a diagnosis of incomplete miscarriage, the midwife should immediately refer the patient to the hospital, since in case of incomplete miscarriage, instrumental removal of the remnants of the fetal egg is indicated.
Cause of abnormal bleeding after abortion
The appearance of bleeding after an abortion should not embarrass the patient, but its duration should be a cause for concern. Among the pathological causes of this symptom are:
- Perforation of the uterus;
- Cervical injury;
- Presence of residual fetal tissue;
- Blood clotting disorder;
- The reaction of the female body to certain anesthetics.
With such diagnoses, along with hemorrhage, there is an obvious violation of the temperature regime, convulsions, general weakness, fainting, hypotension, and increased heart rate. It is important not to ignore such signs of shock, but to promptly visit a medical center and a qualified specialist.
Signs of heavy menstruation
It is possible to independently recognize the presence of heavy periods if the following basic signs are observed:
- the duration of menstrual cycles is less than 21 days;
- using more than three pads per day (indicates blood loss of more than 80 milliliters);
- The menstrual cycle and blood loss continue for more than a week.
Please note that heavy bleeding can be caused by a disease such as anemia or anemia.
Anemia or “tired blood disease” is characterized by a significant decrease in the amount of hemoglobin or red blood cells in a person’s blood. This leads to disruption of the body's functioning.
What to do if there is bleeding after termination of pregnancy
It is important to understand that it is impossible to stop prolonged bleeding after termination of pregnancy at home; only a competent gynecologist can determine an accurate and effective treatment regimen. Delay in this matter may cost the patient her life.
If the visit to the doctor is timely, then first of all the patient is sent for an ultrasound. This precise clinical examination allows us to determine the etiology of the pathological process and the future treatment regimen. If it becomes known that there is residual fetal tissue in the uterus, additional surgical intervention is necessary to properly clean its cavity. In case of mechanical damage to the uterus or its cervix after interruption, the gynecologist prescribes repair of the injured area of the uterus, bladder or intestines.
Signs and causes of anemia
The main causes of anemia are:
- chronic diseases associated with bleeding;
- gastrointestinal tract disorders;
- low iron content in the body;
- heavy and intense physical exercise;
- pregnancy and breastfeeding;
- parasitic diseases;
- excessive use of aspirin.
In order to recognize the disease in time, you need to be familiar with its characteristic symptoms.
Some of the most common signs of anemia include:
- disturbance of vital tone in general;
- increased fatigue and weakness;
- frequent dizziness and fainting;
- rapid pulse and high blood pressure;
- frequent increases in temperature;
- tingling throughout the body;
- pale or yellowish skin;
- brittle nails;
- excessive hair loss;
- violation of taste.
Where to get a medical abortion
Pharmacological abortion is as serious an intervention in a woman’s body as any other type of abortion. Although it is considered more gentle, it has a lot of contraindications and side effects from the drugs. Therefore, you should trust such a procedure only to a trusted medical institution.
Our clinic provides licensed services. Doctors have experience and a well-deserved reputation. They competently select drugs for pharmacological abortion, set the exact dose in order to minimize the negative impact of the drugs on the woman’s health and at the same time achieve a 100% result.
How long does discharge last after an abortion?
The usual duration of discharge is approximately 5-7 days, although sometimes it may stop on the 3rd or 4th day. Reasons for prolonged bleeding:
- An interruption carried out at the deadline. For gentle methods - medical and vacuum abortion, this is approximately 6-7 weeks. The longer the delay, the larger the fertilized egg and the more distended the uterus. Therefore, when it contracts, more blood is released. Termination of pregnancy at the extreme stages of pregnancy with tablets or a vacuum leads to quite long and heavy bleeding. To prevent this from happening, pregnancy must be eliminated as early as possible.
- Interruption technique. Discharge after a classic surgical abortion with curettage lasts much longer than after gentle methods, such as medical abortion
- Reduced contractility of the uterus - this condition can be a congenital developmental feature, but sometimes the organ contracts poorly due to various diseases. Therefore, in patients with gynecological pathologies, bleeding after an abortion lasts longer and is more intense.
- Individual characteristics of the blood clotting system. Some women naturally have worse blood clotting - this also affects the intensity and duration of bleeding.
- Features of the structure and location of the uterus. Even slight displacement and or minor anomalies of the reproductive system prolong the appearance of blood.
Until what time can you have a surgical abortion?
The feasibility and possibility of performing an instrumental abortion is determined on a personal basis. At the request of the pregnant woman, termination can be done up to 12 weeks. Until how many weeks an abortion is performed in general depends on the woman’s motives. At later stages, intervention is carried out only for medical reasons. The maximum period for implementing a surgical abortion is considered to be the 22nd week of gestation.
Discharge after an abortion with clots - is it worth worrying about?
This situation is considered normal, since these clots are blood that has coagulated inside the uterus. Over time, the clots will disappear, the discharge will become liquid, then scanty and disappear completely.
However, if, against the background of such a condition, pain in the lower abdomen suddenly appears, you should definitely consult a doctor. Sometimes a large clot can clog the cervical canal, which runs inside the cervix, and block the outlet for bloody discharge. As a result, blood accumulates in the uterus, leading to a severe complication of hematometra. This situation requires urgent medical attention.
Can there be abnormalities in menstruation after an abortion?
The first menstruation after an abortion may have some deviations. In particular, the first discharge often has a rather unpleasant odor. In some cases, their consistency also changes: if a woman has always had liquid discharge, it may become thicker and vice versa. During the first post-abortion menstruation, some atypical pain in the lower abdomen may appear.
An unusual onset of menstruation should be a reason to seek advice from your treating gynecologist, because if the problem turns out to be serious, it can often lead to further infertility and various intimate problems
How to prevent heavy discharge after an abortion
In order not to provoke increased post-abortion bleeding and to help the body quickly get rid of the consequences of the abortion, after the procedure you cannot:
- Overheat. Baths, saunas, beaches, hot showers and baths are prohibited.
- Be physically active, play sports intensively, lift weights. Such actions cause increased blood flow in the lower abdomen and increased discharge after an abortion.
- Intimate relationships are also prohibited due to blood flow and possible infection. They can be resumed only when the discharge after the abortion ends.
- Drink alcohol, especially strong drinks. Alcohol dilates blood vessels, so it is not recommended to drink it if there is excessive bleeding.
- Take Aspirin, Diclofenac, Ibuprofen, Naproxen, Piroxicam, Nimesulide Analgin, as they can cause bleeding.
In most cases, discharge after an abortion is normal. But there are dangerous complications. The main thing is that if problems arise, do not try to correct the situation yourself, but contact a gynecologist.
MAKE AN APPOINTMENT
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Abortion and contraception clinic in St. Petersburg - department of the medical gynecological association "Diana"
Make an appointment, tests or ultrasound via the contact form or by calling +8 (812) 62-962-77. We work seven days a week from 09:00 to 21:00.
We are located in the Krasnogvardeisky district, next to the Novocherkasskaya, Ploshchad Alexander Nevsky and Ladozhskaya metro stations.
The cost of a medical abortion in our clinic is 3,300 rubles. The price includes all pills, an examination by a gynecologist and an ultrasound to determine the timing of pregnancy.
Why are periods late?
Even after a properly performed abortion, the menstrual cycle may be delayed and begin at a relatively late time. In particular, this may be caused by the slow rate of healing of the lining of the uterus. In order for its recovery to occur as quickly as possible, it is recommended to strictly follow all the instructions of your treating gynecologist.
If you have problems restoring your menstrual cycle after an abortion, this is a reason to seek qualified help from a doctor. Remember that the body is under stress and only an experienced and highly qualified doctor can rehabilitate it.
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How is surgical abortion performed?
The possibility of performing the operation is determined by the gynecologist after examination and determining the exact period of pregnancy. Before an abortion is performed, the woman undergoes training. In the preoperative period, the girl undergoes a urine test, a general blood test, tests for hCG, blood group and Rh factor, as well as screening for infectious diseases (hepatitis, syphilis, HIV). If no contraindications are identified, the doctor sets a date for the intervention, agrees with the patient on the type of pain relief, and, if necessary, gives a referral to an anesthesiologist.
The operation is performed on a gynecological chair using general or local anesthesia. During the intervention, the doctor removes the embryo and performs curettage of the uterus and cervical canal.
The woman spends the early postoperative period in the clinic, under the supervision of medical staff. The patient is prescribed medication, given recommendations regarding the rehabilitation period and set a date for a follow-up visit.
Recovery after an abortion takes 2-3 weeks. During this period, significant stress, sexual contact, thermal procedures, and swimming in the bathroom or open water are contraindicated for a woman. A follow-up examination and ultrasound are performed on the 7th day after surgery. Restoration of hormonal levels and psycho-emotional state (if the outcome of the operation is favorable) takes an average of 3 months.
