Uterine bleeding at 12 weeks gestation accompanied by cervical dilation without passage of tissue.
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Complete abortion
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Incomplete abortion
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Threatened abortion
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Missed abortion
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Inevitable abortion
explanation
Bleeding occurs in about 30% to 40% of human gestations before 20 weeks of pregnancy, with about half of these pregnancies ending in spontaneous abortion. A threatened abortion takes place when this uterine bleeding occurs without any cervical dilation or effacement. In a patient bleeding during the first half of pregnancy, the diagnosis of inevitable abortion is strengthened if the bleeding is profuse and associated with uterine cramping pains. If cervical dilation has occurred, with or without rupture of membranes, the abortion is inevitable. If only a portion of the products of conception has been expelled and the cervix remains dilated, a diagnosis of incomplete abortion is made. However, if all fetal and placental tissue has been expelled, the cervix is closed, bleeding from the canal is minimal or decreasing, and uterine cramps have ceased, a diagnosis of complete abortion can be made. The diagnosis of missed abortion is suspected when the uterus fails to continue to enlarge with or without uterine bleeding or spotting. A missed abortion is one in which fetal death occurs before 20 weeks gestation without expulsion of any fetal or maternal tissue for at least 8 weeks thereafter. When a fetus is retained in the uterus beyond 5 weeks after fetal death, consumptive coagulability with hypofibrogenemia may occur. This is uncommon, however, in gestations of less than 14 weeks in duration.