Classifications of abortion: The Daily PANCE Blueprint

The answer is A. Threatened abortion

In a threatened abortion, vaginal bleeding occurs before 20 weeks gestation without the passage of products of conception. The cervical os remains closed, and there is typically no significant pain. Painless vaginal bleeding in early pregnancy with a closed cervix and uterine size consistent with gestational age is highly suggestive of a threatened abortion. Most women with a threatened abortion will continue their pregnancies without complication.

Incorrect Answers:

• B. Inevitable abortion – An inevitable abortion is characterized by vaginal bleeding, cramping, and dilation of the cervical os, with no passage of products of conception yet. In this patient, the cervical os is closed, which makes inevitable abortion less likely.
• C. Incomplete abortion – An incomplete abortion involves vaginal bleeding, cramping, and the passage of some products of conception through a dilated cervical os. The patient has not passed any tissue, and her cervical os is closed, which does not match this diagnosis.
• D. Complete abortion – A complete abortion occurs after all products of conception have been passed, leading to cessation of vaginal bleeding and a closed cervix. The uterus would appear smaller than expected for gestational age. This patient’s uterine size is consistent with her gestational age, making a complete abortion unlikely.
• E. Missed abortion – A missed abortion involves the death of the fetus without the passage of tissue, typically discovered when fetal heart tones are absent. It is usually asymptomatic or associated with mild spotting, but the uterus is often smaller than expected for gestational age. This is not consistent with the patient’s presentation, where the uterine size matches gestational age, and there are no signs of fetal demise.