A 24-year-old woman with a 14-week incomplete abortion has minimal bleeding and stable vitals. Ultrasound shows retained products measuring 25 mm in AP diameter. The PREFERRED management is:
- A Suction evacuation under ultrasound guidance ✓
- B Expectant management for 2 weeks
- C Misoprostol 600 µg sublingual and discharge home
- D Sharp curettage under general anesthesia
Correct answer: A. Suction evacuation under ultrasound guidance
Explanation
At 14 weeks, retained products of conception represent a second-trimester incomplete abortion. Suction evacuation under ultrasound guidance is the safest and most effective intervention — it completely evacuates uterine contents with direct visualization, reducing risk of perforation compared to blind curettage. Medical management with misoprostol alone has lower complete evacuation rates in second-trimester retained products. Sharp curettage is avoided in favor of suction due to lower uterine perforation risk.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.