A 22-year-old woman at 9 weeks presents with heavy bleeding, pain, and passage of tissue. Ultrasound shows an empty uterus with no products of conception. β-hCG is 320 mIU/mL (was 3200 mIU/mL 48 hours ago). What type of abortion does this represent?
- A Complete abortion ✓
- B Inevitable abortion with impending expulsion
- C Missed abortion (missed miscarriage)
- D Threatened abortion
Correct answer: A. Complete abortion
Explanation
Complete abortion is defined by complete expulsion of all products of conception (POC), reflected by an empty uterus on ultrasound, cessation or reduction of bleeding, and appropriately falling β-hCG (typically > 50% decline per 48 hours as in this case: 3200 to 320 = 90% decline). No further intervention is required if the patient is clinically stable. Missed abortion has a non-viable gestation with closed os and retained POC. Inevitable abortion shows cervical dilation with products in the cervical canal. Threatened abortion presents with a closed cervix and viable pregnancy.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.