A 26-year-old primigravida at 9 weeks of gestation presents with 2 days of painless vaginal spotting. Speculum examination shows old blood in the vault, the internal os is closed, and the uterus corresponds to 9 weeks size. Transvaginal ultrasound shows a live fetus with cardiac activity matching dates. What is the diagnosis?

• A Inevitable abortion
• B Incomplete abortion
• C Missed abortion
• D Threatened abortion ✓

Explanation

Threatened abortion is defined as vaginal bleeding before 20 weeks with a closed internal os and a viable pregnancy; roughly half continue to term. Inevitable abortion is killed by its defining sign, an open internal os with products still in utero, which is absent here. Incomplete abortion requires partial expulsion of products, and missed abortion implies fetal demise without symptoms.

Reference: Williams Obstetrics, 25th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.