All of the following are symptoms of incomplete abortion, except?

Appeared in: PGIMS Rohtak NO - 2017

Explanation

Incomplete abortion is defined by the partial expulsion of the products of conception from the uterus.
For the remaining tissue to pass, the cervical os must be open or dilated.
A closed cervical os is therefore not a feature of incomplete abortion.
A closed os is typically seen in a threatened abortion (before tissue has passed) or a complete abortion (after all tissue has passed).

Option A: A history of bleeding per vaginum is a cardinal symptom of incomplete abortion, resulting from the separation of the placenta from the uterine wall.
Option B: In an incomplete abortion, the uterine size is typically smaller than expected for the period of amenorrhea because a portion of the uterine contents has already been expelled.
Option D: A history of passing some tissue (products of conception) is the defining characteristic of an incomplete abortion, distinguishing it from an inevitable abortion where the os is open but no tissue has passed yet.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Differential diagnosis of spontaneous abortion, specifically the clinical presentation of incomplete abortion as background academic context rather than a clinical decision trigger.
The immediate nursing priority for a patient with a suspected incomplete abortion is to assess hemodynamic stability by monitoring vital signs, level of consciousness, and the amount of vaginal bleeding (pad count).
Nurses should prepare for potential interventions, including starting an IV line for fluid resuscitation, drawing blood for a complete blood count and type and crossmatch, and preparing the patient for a possible uterine evacuation (e.g., dilation and curettage).
It is crucial to administer Rh(D) immunoglobulin to Rh-negative women to prevent future isoimmunization.

How to Approach the Question

First, identify the keyword 'except' in the question stem. This indicates you are looking for the option that is NOT a symptom of incomplete abortion.
Recall the definition of incomplete abortion: some products of conception have passed, but some remain in the uterus.
Think through the process: For tissue to pass out of the uterus, the cervix (os) must be open.
Evaluate each option based on this understanding:
Bleeding is expected as the placenta detaches.
A smaller uterus is logical since some contents have been expelled.

Concept Tested & Keywords

Concept Tested: Differential diagnosis of spontaneous abortion, specifically the clinical presentation of incomplete abortion.
Stem keywords: incomplete abortion, symptoms
Lead-in keywords: except
Negative lead-in flag: The question asks to identify the feature that is NOT a symptom of incomplete abortion.

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E6 Gynecology Williams p. 152-181

E6 Obstetrics Williams p. 3

Practise the full PGIMS Rohtak NO - 2017

Attempt every question from this paper in a timed mock, then review the full solution for each one.