A 22 year old woman who was diagnosed with a missed miscarriage a week ago presented to the hospital last night with abdominal pain and vaginal bleeding. Since then, she has passed a small fetus. A transvaginal ultrasound was repeated which showed an empty uterus. The pain is slowly easing off. What is the SINGLE most likely diagnosis?
A. Threatened miscarriage
B. Inevitable miscarriage
C. Incomplete miscarriage
D. Complete miscarriage
E. Spontaneous miscarriage
Complete miscarriage is a spontaneous abortion with expulsion of the entire fetus through the cervix. Pain and uterine contractions cease after fetus has been expelled. An ultrasound scan would show an empty uterus. A short summary of types of miscarriages that are commonly asked in PLAB Threatened miscarriage → Vaginal bleeding + fetal heart seen. Cervical os is closed Missed miscarriage (delayed miscarriage) → Dead fetus before 20 weeks without the symptoms of expulsion. May or may not have vaginal bleeding. Cervical os is closed. Inevitable miscarriage → Cervical os opened and bleeding Incomplete miscarriage - Not all products of conception have been expelled Complete miscarriage - Everything has been expelled