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OBG · Early pregnancy: miscarriage
Sample itemA patient at 9 weeks has vaginal bleeding and cramping. Ultrasound shows an intrauterine gestational sac with an embryo but no cardiac activity, meeting accepted nonviability criteria. What is the most likely diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Missed miscarriage
A missed miscarriage is nonviable intrauterine pregnancy retained in the uterus, often with absent embryonic cardiac activity on appropriately performed ultrasound. Management options depend on clinical stability and patient preference.
Option by option
A. Missed miscarriage (correct)
Correct. A nonviable embryo retained in the uterus defines missed miscarriage.
B. Complete miscarriage
Complete miscarriage has already expelled all products of conception.
C. Threatened miscarriage
Threatened miscarriage has bleeding with a viable intrauterine pregnancy and closed cervix.
D. Ectopic pregnancy
An ectopic pregnancy is implanted outside the uterine cavity.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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