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What is A 25 years old female reports in the casualty with history of amenorrhoea for two and half months and abdominal pain and bleeding per vaginum for one day. On examination, vital parameters and other systems are normal. On speculum examination, bleeding is found to come from Os. On bimanual examination, uterus is of 10 weeks size, soft and Os admits one finger. The most likely diagnosis is: and explain in detail?
Ans. is c, i.e. Inevitable abortionRef. Dutta Obs 7/e, p 161, 162Clinical features and diagnosis of different types of AbortionsAbortionClinical pictureSize of uterusInternal osUltrasound1. ThreatenedSlight bleedingCorrespondsClosedLive fetus, subchorionic hemorrhage2. InevitableBleeding and pain, shockEqual or lessOpen with products feltDead fetus3. IncompleteBleedingSmallerOpenRetained products4. CompleteBleeding stoppedSmallerClosedCavity empty5. MissedAbsent or minimal bleedingSmallerClosedDead fetusIn both the question, os is open, size of uterus corresponds to period of amenorrhea and product of conception cannot be seen coming out from os. Thus, it indicates inevitable abortion.