A patient at 22 weeks gestation is diagnosed as having IUD which occurred at 17 weeks but did not have a miscarriage. This patient is at increased risk for:
**Core Concept**
The patient is at 22 weeks gestation with an intrauterine death (IUD) that occurred at 17 weeks. This situation is known as a missed abortion, where the fetus has died but the body has not expelled it. The risk of complications arises due to the prolonged presence of the dead fetus and its potential effects on the mother's health.
**Why the Correct Answer is Right**
The presence of a dead fetus in the uterus can lead to infection (sepsis) and hemorrhage due to the breakdown of the placental tissue. This is because the dead tissue becomes a culture medium for bacteria, which can cause an infection. Additionally, the prolonged presence of the dead fetus can cause the uterus to become infected, leading to sepsis and potentially life-threatening complications. The risk of sepsis is increased due to the presence of bacteria such as Escherichia coli, Group B streptococcus, and Clostridium perfringens.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is not relevant to the situation described, as there is no mention of a patient with a history of multiple gestations or a patient with a history of cervical surgery.
**Option B:** This option is not directly related to the patient's situation, as the patient is not described as having a history of autoimmune disorders or collagen vascular diseases.
**Option C:** This option is not the most likely complication in this situation, as the patient is not described as having a history of diabetes or hypertension.
**Clinical Pearl / High-Yield Fact**
It is essential to diagnose and manage a missed abortion promptly to prevent potential complications such as sepsis and hemorrhage.
**Correct Answer:** C. Hemorrhage