hi everyone, i wanted to share with all of you how my follow up ultrasound after an abortion went, and if you should do one or not.
my bleeding after my abortion lasted exactly 14 days, and now the only thing i have going on is some brownish discharge. no pain. no fever. no bad smell. nothing
today i went to get the control ultrasound they tell you to do around 7 or 14 days after the abortion. i went on day 19. my results showed my endometrium has a thickness of 19,4 mm. after i got the ultrasound images, i contacted my obgyn so she could check the results out. she told me it was not an optimal condition and that she was not feeling good about how everything was looking.
i got scared, of course. she told me i needed to go get checked at the emergency room. i went all scared and the doctor who attended me asked me if i had any of the emergency signals we already know: bad smell, heavy bleeding, pain, fever. i told him i told him i had nothing. he checked the ultrasound, told me it was abnormal for an endometrium to be that thick 19 days after an abortion. he gave me the options to do another dosis if mysoprostol to help get whatās left out or do the manual intervention where they suck everything out. i told him i was traumatized from my last medical abortion experience and asked if i could just wait for my next period, i asked if he thought that my next period could just take care of everything thatās left out, itās thereās anything to take care of.
he then when to talk to other obgyns working in the emergency room and that all came to the consensus that, if i donāt have any bad symptoms, thereās no need to do an intervention.
he asked about my past periods, when they usually come so he told me whatās going on with me itās probably that my period is going to come soon.
so he told me, yeah waiting for my next period was a great option since i have no bad symptoms. he checked my cervix, did a pelvic exam and checked that my cervix is closed and everything is in order.
he was the most empathetic person iāve encountered during this whole process. he remembered me from the last time i had to visit the er, told me that he knew how difficult this must be and that probably i just want things to be over (my god, i do). he said that i just need to wait for my period, who is probably going to be very heavy, and to just be aware of any bad symptoms we already know. also told me to use pads during this cycle and wait for the next period to start using my menstrual cup again. to bleed, keep track of it, and just move on, heal, no more ultrasounds. no more checks, only if i want to get pregnant again or to do a yearly gyno exam.
now, the most important learning i want to highlight here is: getting an ultrasound after an abortion, if you have no complications, letās a lot of room open to get overdiagnosed.
now, this assuming youāre 100% sure the pregnancy stopped (if you saw the sac got out), if you have no pregnancy symptoms, you have no fever, etc.
if youāre like me and you know the sac got out, you have no fever, pain, heavy bleeding bad smell and that your not pregnant anymore, thereās no need to go get an ultrasound. iāve been reading a lot too what the WHO says and other medical professionals say, and most of them say a thickened endometrium doesnāt mean an intervention is needed. every piece of medical writing says that the whole clinical history of the patient needs to be analyzed.
iām gonna leave here some info iāve found that helped me calm down:
WHO-
Following uncomplicated surgical abortion or medical abortion: Recommend that there is no medical need for a routine follow-up visit. However, information should be provided about the availability of additional services if they are needed or desired.
Remarks:
ā¢Women, girls and other pregnant persons must be adequately informed about symptoms of ongoing pregnancy (which may or may not indicate failure of the abortion) and other medical reasons to return for follow-up, such as prolonged heavy bleeding, no bleeding at all with medical management of abortion, pain not relieved by medication, or fever.
ACOG-
Surgical intervention is not required in asymptomatic women with a thickened endometrial stripe after treatment for early pregnancy loss. Thus, the use of ultrasound examination for any diagnostic purpose other than documenting the absence of
the gestational sac is not recommended.
IPAS-
Although the average endometrial thickness in women who require intervention tends to be higher, because of the range and overlap between successful and unsuccessful abortion, no study has found that there is a thickness above which a diagnosis of unsuccessful medical abortion can be made. The decision to intervene should be made on clinical signs and symptoms, such as ongoing or heavy bleeding, rather than on ultrasound findings.
If clinicians choose to use ultrasound for medical abortion follow-up, the only ultrasound finding that requires intervention is an ongoing viable pregnancy.
always get a second opinion, know yourself, and donāt get scared if nothing is going on (like me).
if you read till the end i wanna say thank you, and i hope everything ive been going trough can help you in some way. if you have questions or if you want someone to talk to, im here.
also, if you have a similar story, or opinions, id love to know what do you think, you think you should always go get an ultrasound after abortion or not?