A series of pregnant patients present to the obstetric triage unit during their first trimester for evaluation of potential pregnancy loss. Match each clinical and ultrasonographic presentation to the most accurate diagnosis.
- Threatened abortionVaginal bleeding, closed cervical os, viable intrauterine pregnancy with normal fetal cardiac activity
- Inevitable abortionVaginal bleeding, dilated cervical os, products of conception present in the lower uterine segment without expulsion
- Incomplete abortionVaginal bleeding, dilated cervical os, partial expulsion of products of conception with retained heterogeneous tissue in the uterus
- Missed abortionAsymptomatic or loss of pregnancy symptoms, closed cervical os, embryo present without fetal cardiac activity
Cevap
Threatened abortion matches the presentation of a closed os with a viable pregnancy. Inevitable abortion matches a dilated os without expulsion of tissue. Incomplete abortion matches a dilated os with partial expulsion of tissue. Missed abortion matches a closed os with a nonviable pregnancy.
The clinical diagnosis of early pregnancy loss subtypes relies on three classic features: the presence or absence of vaginal bleeding, the dilation status of the cervical os, and the pelvic ultrasound findings regarding the products of conception. A closed os with a live fetus indicates a threatened abortion. A dilated os with an intact but nonviable pregnancy in the lower segment is an inevitable abortion. A dilated os with partially passed tissue is an incomplete abortion. A closed os with a dead fetus and no active bleeding is a missed abortion.
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Anahtar Kavram
Classification of early spontaneous abortion based on cervical os status and ultrasonographic findings.