See also: 
     Vaginal bleeding Ddx
     Medical abortion
Hx
     Pregnant patient
     Lower abdominal pain
     Vaginal bleeding
Workup
     Pelvic exam
     Urine hCG
     U/S-pelvis
     CBC
     PT/PTT
     Quantitative serum hCG
Missed abortion
     Document the absence of fetal heart movement on ultrasound.
     May get coagulation studies as retained products of conception (POC) can rarely cause coagulopathy.
     Ensure that there is complete elimination of the POC from the uterus, this may be done:
          Surgically with dilation and curettage
          Medically with vaginal misoprostol or PO mifepristone (RU486)
          Expectantly by simply monitoring the mother with serial imaging
Complete abortion
     A form of spontaneous abortion where the whole conceptus passes through the cervix.
     The cervix then closes, and the associated pain and uterine contractions subside.
     Ultrasonography shows an empty uterus.
Incomplete abortion
     Implies the evacuation of some of the fetal tissue while the remainder is retained in the uterine cavity.
Threatened abortion
     Refers to any hemorrhage from the uterine cavity occurring before the 20th week of gestation with a live fetus.
     The cervix is closed and there is no passage of fetal tissue.
     Mild lower abdominal pain may be noted, and the fetal heart is active on ultrasound.
Inevitable abortion
     Presents as
          Vaginal bleeding
          Lower abdominal cramps
          Dilated cervix
     Ultrasonography demonstrates a ruptured or collapsed gestational sac with absence of fetal cardiac motion

Content on this page has not been checked for accuracy. The author's credentials have not been confirmed. Always use multiple peer-reviewed scholarly sources and good clinical judgement in your decision making.

The Compendium platform was created by David Kwinter, MD, CCFP(EM).

Dr. Kwinter is a Cayman Family Doctor. He runs a Family Medicine Clinic at Cayman Medical in George Town, Grand Cayman, Cayman Islands.