Friday, April 2, 2010

Because I Could Not Stop for Death

A 35 year old woman presents with pelvic discomfort. She hasn't had a menstrual period in six weeks but yesterday began to have some vaginal spotting with mild suprapubic pain. She is sexually active with two partners. She has smoked one pack of cigarettes a day for 5 years and is a moderate to heavy drinker.

On exam, you note a closed cervical os. A urine pregnancy test is positive. An ultrasound shows a long, closed cervix with uterine size appropriate for gestational age.

Challenge: What "kind" of abortion is this?

5 comments:

Mike said...

Threatened Abortion?

Anonymous said...

spontaneous

Joe said...

Imminent Abortion...

K said...

Threatened abortion?

Craig Chen said...

yes..threatened or imminent. no abortion yet. if fetus is at the right gestational age, heart tones may be doppler-able.
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Because I Could Not Stop for Death

Emily Dickinson's poem begins: "Because I Could Not Stop for Death / He kindly stopped for me / The carriage held but just ourselves / And Immortality." The case described here is a threatened abortion because it is bleeding through a closed cervical os.

Source: UpToDate.