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A 35-year-old gravida 3, para 2, last menstrual period 11 weeks ago, presents with an undesired pregnancy. Her prior pregnancies were uncomplicated vaginal deliveries. Her ultrasound confirms an 11-week intrauterine pregnancy. She has no relevant past medical or surgical history. She is currently taking prenatal vitamins and has no known drug allergies. After counseling, she chooses to proceed with a surgical abortion. After the administration of 200 mg of oral doxycycline, a suction dilation and curettage (D&C) is performed under moderate sedation. After the procedure, she has persistent heavy vaginal bleeding.
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