A 25 year old primigravida at 10 weeks pregnancy presents with abdominal pain and bleeding per vaginum. BP is 118/74 mm Hg & on speculum examination, bleeding is found to come from Os. On Per Vaginum, uterus is of 10 weeks size, soft and Os is open 1.5cms. diagnosis?
## **Core Concept**
The clinical presentation described points towards a condition complicating early pregnancy, characterized by abdominal pain and vaginal bleeding. The key details include the gestational age (10 weeks), the source of bleeding (from the os), the size of the uterus corresponding to gestational age, and the cervix being open.
## **Why the Correct Answer is Right**
The correct diagnosis of **Incomplete Abortion** is based on the symptoms and signs presented:
- The patient is at 10 weeks gestation with abdominal pain and vaginal bleeding, which are common presentations for complications in early pregnancy.
- The bleeding is from the os, indicating the source is within the uterus.
- The uterus is soft and of appropriate size for 10 weeks gestation but the os is open at 1.5 cm, which is crucial.
- In incomplete abortion, there is partial expulsion of the products of conception, which would cause the os to be open and lead to bleeding.
## **Why Each Wrong Option is Incorrect**
- **Option A (Threatened Abortion):** This condition presents with bleeding in early pregnancy but the cervix is closed, which does not match the given scenario of an open os.
- **Option B (Missed Abortion):** This condition involves fetal demise with the products of conception retained in the uterus, typically with a closed os, which does not fit the provided clinical picture.
- **Option D (Complete Abortion):** In complete abortion, all products of conception are expelled, and the uterus is usually smaller than expected, and the os would typically be closed, not open as described.
## **Clinical Pearl / High-Yield Fact**
A key point to remember is that the status of the cervix (open vs. closed) and the uterine size versus gestational age are critical in differentiating between types of abortion. Specifically, an open os with a soft uterus and partial products of conception expelled points towards **incomplete abortion**.
## **Correct Answer:** C. Incomplete Abortion