A 29-year-old primigravida presents at 8 weeks with painless spotting. Transvaginal ultrasound shows a live embryo matching dates with a small subchorionic collection. What is the most appropriate next step?

• A Administer anti-D immunoglobulin
• B Start intramuscular progesterone 100 mg daily
• C Perform suction evacuation
• D Reassurance with a follow-up scan in 1 to 2 weeks ✓

Explanation

This is a threatened abortion with a confirmed viable embryo; the large majority of such pregnancies continue to term, so reassurance and follow-up imaging are appropriate. Routine progestogen is not indicated for first-time threatened abortion in current evidence-based practice, and evacuation is reserved for non-viable pregnancies. Anti-A is relevant only for an Rh-negative unsensitised woman, which the vignette does not establish.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.