What does it feel like if the gestational sac hasn't passed?

When the gestational sac has not been expelled, symptoms may generally include persistent vaginal bleeding, continuous lower abdominal pain, ongoing early pregnancy reactions such as nausea and vomiting, obvious soreness and heaviness in the lower back, and abnormal vaginal discharge. Detailed analysis is as follows:

1. Persistent vaginal bleeding: When the gestational sac has not been expelled, the endometrium cannot heal properly, leading to persistent vaginal bleeding. The amount of bleeding may vary, often bright red or dark red in color, sometimes accompanied by small blood clots. The duration of bleeding typically exceeds that of normal post-abortion bleeding and does not stop spontaneously.

2. Continuous lower abdominal pain: The uterus continuously contracts in an attempt to expel the gestational sac, causing persistent lower abdominal pain. The pain is usually described as dull or a sensation of pressure, and may occur in episodic waves with increasing intensity. It is primarily located in the central lower abdomen and may worsen upon palpation.

3. Persistence of early pregnancy symptoms such as nausea and vomiting: When the gestational sac remains, hormone levels (such as human chorionic gonadotropin) remain elevated, so symptoms like nausea, vomiting, loss of appetite, and breast tenderness do not significantly improve or disappear and may persist.

4. Obvious lower back soreness and pressure: Uterine contractions and pressure from the gestational sac on surrounding tissues can cause a pronounced aching and heavy sensation in the lower back, along with discomfort and pressure in the lower abdomen. These sensations become more noticeable after physical activity and are difficult to relieve even with rest.

5. Abnormal vaginal discharge: In addition to bleeding, the vagina may discharge small amounts of abnormal secretions, which may appear brown, grayish-white, and sometimes have a slight odor—markedly different from normal leukorrhea—suggesting possible intrauterine residue or mild infection.

If any of the above symptoms suggesting retained gestational sac occur, especially after a miscarriage, it is important to seek medical attention promptly for an ultrasound examination to confirm whether tissue remains. Once diagnosed, follow the doctor's recommendations for treatment, which may include medication or surgical evacuation (dilation and curettage), to prevent complications such as infection or excessive bleeding due to prolonged retention, which could affect reproductive health.