Ask Mac – Questions ListCategory: AnalgesiaPain Management with Abortions
asked 11 months ago
I recently had a patient who had taken misoprostol and mifepristone for an abortion. We were called due to abdominal pain and vaginal bleeding. The patient hadn’t been advised on any pain medication to take so I’m wondering what the viewpoint of base hospital is on pain management for the patients due to the vaginal bleeding and potential for the patient to become hypotensive due to potentially excessive bleeding.
1 Answers
answered 11 months ago
Thank you for your question. The use of acetaminophen, ibuprofen and Toradol would be appropriate options in treating pain in this clinical scenario. Acetaminophen is not associated with risk of bleeding. Although there is a low risk of GI bleeding with ibuprofen and Toradol, the use of these NSAIDS in this clinical scenario would be beneficial for pain control and would not increase the risk of vaginal bleeding. NSAIDS reduce the production of prostaglandins which helps to control pain, but they can also help control menstrual flow due via mechanisms on the uterine lining. The use of narcotics would also be appropriate for ACP providers. 
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