A lady with 12-week pregnancy with bleeding and on examination vagina is normal, Internal OS is closed and live bih sign on USG and fundal height is 13 weeks. Diagnosis;
First, the core concept here is likely about early pregnancy complications. The key points are bleeding in pregnancy, closed cervix, and the USG findings. The presence of a live bih (probably bih sign is a typo for "fetal heart" or "bih" as in "bih" meaning "bih" could be a typo. Wait, maybe "live bih sign" refers to a fetal heartbeat detected on USG. So, the patient has a live fetus. The fundal height is 13 weeks, which is a week ahead of the gestational age.
Possible diagnoses for bleeding in early pregnancy include threatened abortion, complete abortion, inevitable abortion, or ectopic pregnancy. But since the internal OS is closed and USG shows a live fetus, it's more likely threatened abortion. In threatened abortion, the cervix is closed, and the pregnancy is still viable. If the cervix is open, it's inevitable. If the USG shows no heartbeat, it might be a missed abortion. But here, the fetus is alive.
The fundal height being 13 weeks could be due to increased amniotic fluid or a more advanced pregnancy than the last menstrual period suggests. But in threatened abortion, the fundal height might be normal or slightly larger due to bleeding.
Now, looking at the options. The correct answer is probably threatened abortion. The other options could be complete abortion (cervix open, no live fetus), inevitable abortion (cervix open), or ectopic (USG would not show intrauterine live fetus).
Clinical pearl: Threatened abortion is diagnosed when there's bleeding but the cervix is closed and the pregnancy is viable. Management is supportive, with rest and monitoring. The key is that the internal OS remains closed, which differentiates it from inevitable.
**Core Concept**
This question assesses the diagnosis of early pregnancy complications, focusing on distinguishing *threatened abortion* from other types of miscarriage based on clinical findings. Key indicators include cervical status, fetal viability on ultrasound, and gestational age correlation with fundal height.
**Why the Correct Answer is Right**
The diagnosis is **threatened abortion**. The patient has vaginal bleeding in early pregnancy, but the internal cervical os is *closed* (ruling out inevitable abortion), and ultrasound confirms a *live intrauterine pregnancy* (ruling out missed abortion). Fundal height slightly exceeding gestational age (13 weeks vs. 12 weeks) may reflect uterine bleeding or slightly increased amniotic fluid. Threatened abortion is characterized by bleeding with a viable fetus and closed cervix, often resolving spontaneously.
**Why Each Wrong Option is Incorrect**
**Option A:** *Inevitable abortion* is incorrect because the internal cervical os is closed. Inevitable abortion involves an open cervix with inevitable loss of the pregnancy.
**Option B:** *Complete abortion* is incorrect because there is no evidence of expelled products of conception or an empty uterus.
**Option C:** *Ectopic pregnancy* is incorrect