A 33-year-old woman with one previous delivery by C-section received mifepristone followed by misoprostol at 48 days' gestation. Two hours after ingesting the misoprostol, she contacted her provider's office to complain of persistent nausea and two episodes of vomiting. She reported having had nausea intermittently for the previous 2 weeks but stated, "It has never been this bad, and I haven't vomited before." She asked if there were any medications she could take to relieve her distress.
Resolution of Case 3
The fact that the patient reported nausea intermittently for the previous 2 weeks suggests that the pregnancy itself caused this symptom. Her report of more severe nausea as well as vomiting during the abortion process, however, is probably due to misoprostol. When the provider reminded her that these symptoms are common side effects of the medications used to induce a medical abortion, the patient felt reassured. In the course of the phone conversation, the provider offered to call in a prescription for prochlorperazine to suppress the nausea, but the patient opted instead for a "watchful waiting" approach. The provider also suggested the patient increase her fluid intake to avoid dehydration. She passed the pregnancy an hour after the phone call, and the nausea and vomiting abated 30 minutes later.
Return to Expected Side Effects of Medical Abortion.
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