Vaginal bleeding Ddx
Lower abdominal pain
Quantitative serum hCG
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
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.
Implies the evacuation of some of the fetal tissue while the remainder is retained in the uterine cavity.
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.
Lower abdominal cramps
Ultrasonography demonstrates a ruptured or collapsed gestational sac with absence of fetal cardiac motion