Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for evaluation of pregnancy status. Reports absence of vaginal bleeding or pelvic pain. Known intrauterine pregnancy by LMP/ultrasound. Denies passage of tissue or fluid. Patient reports resolution of pregnancy symptoms (nausea, breast tenderness).
Clinical Examination Findings
Vitals stable. Abdominal exam: soft, non-tender, no guarding or rebound. Pelvic exam: cervix closed, no active bleeding, no cervical motion tenderness, uterus size consistent with or smaller than dates, no adnexal masses or tenderness.
Treatment Protocol
Diagnosis of missed abortion confirmed via ultrasound (absence of fetal cardiac activity). Options discussed: expectant management, medical management (misoprostol), or surgical management (D&C). Patient counseled on risks of infection, hemorrhage, and incomplete evacuation. Rh status checked; RhoGAM administered if indicated.