BLEEDING EXPERIENCE AFTER MEDICATION ABORTION PRIOR TO FETAL CARDIAC ACTIVITY

Objectives

The purpose is to elucidate the bleeding experience after very early medication abortion in the setting of an abortion ban at fetal cardiac activity. The aims are to characterize the duration and quantity of bleeding and cramping, symptoms, and efficacy.

Methods

This is a prospective cohort study. A survey was administered prior to abortion initiation. Follow-up surveys were administered via text message daily for three days, weekly for four weeks, and once at six weeks. Chart abstraction was performed to obtain demographic and follow-up data.

Results

Some 250 participants were enrolled. At baseline, 73% of respondents reported typically moderate menses and 76% reported pregnancy symptoms. On days 1-3, participants reported bleeding at rates of 84.4%, 95.6%, and 98.4%, respectively. Less than half of respondents reported bleeding heavier than menses. Cramping on days 1-3 was noted at rates of 88.0%, 86.7%, and 79.2%, respectively. More than half of respondents reported cramping heavier than with menses on days one and two. At one week, 93.2% reported continued bleeding, with 24.0% heavier, 30.0% like, and 46.0% lighter than menses; 51.6% reported cramping, and 65.2% reported pregnancy symptoms resolved. At two weeks, 51.9% reported bleeding, 29.9% reported cramping, and 65.6% reported pregnancy symptoms resolved. At six weeks, approximately 73.0% of respondents had resumed menses while 11.3% had a positive pregnancy test.

Conclusions

Bleeding with medication abortion prior to fetal cardiac activity was similar to menses while cramping was heavier. Bleeding, cramping, and pregnancy symptoms had resolved by two weeks in most patients. Patient counseling on expectations should be adjusted accordingly.