Taking too long to physically recover after miscarriage

Patient

Q: I am 29 years old. I had a miscarriage on Dec 12, using misoprostol, after learning I had a blighted ovum at 12 weeks. Severe cramping lasted 4 days, I bled heavily for 6 days. Now, 9 days later, the bleeding has almost stopped, but I still feel exhausted, weak in the knees, and very lightheaded. My GP ran a bunch of bloodwork on dec 17 and said there were no flags. My OB did a follow-up ultrasound on Dec 14 and said everything looked like it was going well. When I called both my GP and my OB about the dizziness and fatigue yesterday (Friday) both agreed that it was not normal, but neither had any idea of why I was experiencing these symptoms or how to get over this more quickly. All they suggested was that I make sure in eating well and drinking plenty of water, which I have been doing. Today, dec 20, I'm very lightheaded and having bad cramps again, although I haven't had any bleeding more about 24 hours. I'm concerned about missing any more work, and scared of what may be wrong. And insight would be appreciated.

Symptoms:  Lightheadedness, weakness, fatigue, dizziness, cramping
Doctor

A:   Hello,
If you have had abortion by Dec 12 and have bleed heavily for next 6 days , and have been off bleeding for just 24 hrs now, the symptoms of light headedness, dizziness can be attributed to heavy blood loss possibly causing anemia. Also , the sudden onset of crampings may indicate retained products of conception which is quite common in a 12 week pregnancy when aborted with misoprostol. Even though an ultrasound was done on the second day following abortion, and showed still thickened endometrium and decidua, the ideal time for repeating it is after 1 week of stoppage of bleeding to reconfirm completion of abortion and no products left behind. It then gives a clearer picture.

There is a possibility that you may start bleeding again and may pass few clots to remove the remnants and the pain should stop after the bleed. Please keep yourself well hydrated to maintain the blood volume and escape dizzy spells. Also hot fomentation to lower abdomen would soothen the pain , you may use it as often as required. Maintain adequate rest till you feel better and work can be postponed for a week till completion is confirmed by a repeat ultrasound showing thinned endometrial thickness again.

I hope i have answered your query in detail,
wishing you good health,
regards

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