Threatened abortion vs Inevitable, incomplete, complete, and missed abortion
How to tell Threatened abortion and Inevitable, incomplete, complete, and missed abortion apart when a board question makes them look alike.
Threatened is bleeding with closed os and viable pregnancy; inevitable/incomplete have open os, complete empties uterus, missed retains nonviable pregnancy.
Side by side
Threatened abortion is vaginal bleeding before 20 weeks with a closed cervical os and a viable intrauterine pregnancy.
Inevitable abortion has open os without expulsion; incomplete has partial tissue passage; complete has full expulsion; missed has nonviable pregnancy retained with closed os.
Bleeding occurs while the pregnancy may still continue because the cervix remains closed and fetal cardiac activity may be present.
Pregnancy loss progresses through cervical dilation, tissue expulsion, retained products, or fetal demise without expulsion.
Closed os, viable intrauterine pregnancy on ultrasound, bleeding, and gestational age below 20 weeks support threatened abortion.
Open os, products of conception, absent fetal cardiac activity, empty uterus after tissue passage, or retained nonviable pregnancy support other abortion categories.
The trap
Bleeding alone does not classify early pregnancy loss; cervical os, viability, and tissue passage decide the label.
The repair move
For early pregnancy bleeding, check cervical os, ultrasound viability, and whether tissue has passed.
Try a free question
CoreA 24-year-old G1 at 9 weeks gestation has 2 days of light vaginal spotting and mild cramping. Vital signs are normal. Pelvic exam shows a closed cervical os with scant blood. Transvaginal ultrasound shows an intrauterine gestational sac with a fetal pole and cardiac activity at 168/min. Which diagnosis is most appropriate?
Show answer and explanation
Answer: A. Threatened abortion. Threatened abortion is vaginal bleeding before 20 weeks with a closed cervical os and a viable intrauterine pregnancy; about 50% proceed normally.
Why the other choices are tempting
- B. Inevitable abortion has an open cervical os without expulsion of products.
- C. Incomplete abortion has partial passage of products with an open cervical os and retained tissue.
- D. Complete abortion has full expulsion of products with closed os and empty uterus.
- E. Missed abortion has fetal demise without expulsion; cardiac activity at 168/min excludes this.
Flashcards
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What defines threatened abortion?
Bleeding before 20 weeks with closed os and viable pregnancy defines threatened abortion.
What defines inevitable abortion?
Open cervical os without completed expulsion defines inevitable abortion.
Quick answers
What is the fastest way to tell Threatened abortion from Inevitable, incomplete, complete, and missed abortion?
Threatened is bleeding with closed os and viable pregnancy; inevitable/incomplete have open os, complete empties uterus, missed retains nonviable pregnancy.
What is the key clue for Threatened abortion?
Threatened abortion is vaginal bleeding before 20 weeks with a closed cervical os and a viable intrauterine pregnancy.
What is the key clue for Inevitable, incomplete, complete, and missed abortion?
Inevitable abortion has open os without expulsion; incomplete has partial tissue passage; complete has full expulsion; missed has nonviable pregnancy retained with closed os.
What is the common trap with Threatened abortion vs Inevitable, incomplete, complete, and missed abortion?
Bleeding alone does not classify early pregnancy loss; cervical os, viability, and tissue passage decide the label.