<s>[INST] I had 800mcg misoprostal PV yesterday, severe cramping and a slight increase in PV loss but no tissue.  I have previously had 2 Caesarean sections, does this mean the miso is not working or could it still take time?  I have a blighted ovum but am 13 weeks by dates [/INST] Hi, I have gone through your question, and I think I have understood your concern. I will suggest you the best possible treatment options.1 )  First of all do not panic. 2 ) The cramping is due to severe muscular contractions of the uterus. It is bound to happen when you take  800 mcg  of  Misoprostol .3 )  You can repeat the dose of Misoprostol for one time. Please avoid taking preparations containing paracetamol or voveron  type medicines. 4 )  if you do not experience passage of clots , please do USG test .  If pregnancy products are not completely expelled out of uterus then you need to undergo surgical evacuation.  Also , please have appropriate antibiotics cover.I hope this answer helps you Thanks Dr Purushottam Neurgaonkar </s>