A woman presents with incomplete abortion at 10 weeks (products of conception seen in uterine cavity, cervical os open, bleeding moderate). She is haemodynamically stable. What is the most appropriate management?
- A Suction evacuation of the uterus ✓
- B Expectant management for 1 week
- C Sharp curettage under general anaesthesia
- D Misoprostol 400 µg sublingually and discharge
Correct answer: A. Suction evacuation of the uterus
Explanation
Incomplete abortion at 10 weeks with visible POC, open os, and ongoing bleeding requires active intervention. Suction evacuation (MVA or EVA) is the preferred method — it is safer than sharp curettage, with lower risk of uterine perforation and Asherman syndrome. Medical management (misoprostol) can be used in selected stable early incomplete abortions (<13 weeks) but suction evacuation at 10 weeks with active bleeding is the preferred standard of care. Expectant management at this gestation with retained POC and bleeding is inappropriate.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.