Retaining a dead fetus inside the uterus for a few weeks is known as?

AIIMS Raipur - 2017 (shift-2)

Obstetrics & Gynaecology

Easy

Appeared in: AIIMS Raipur - 2017 (shift-2)

Explanation

A missed abortion is defined as the intrauterine retention of a dead fetus for a period of days or weeks.
In this condition, the cervix remains closed, and the typical signs of miscarriage, such as heavy bleeding and uterine cramping, are absent.
The diagnosis is confirmed by ultrasound, which shows an embryo or fetus without cardiac activity.
Symptoms of pregnancy often disappear, and the woman might notice a brownish vaginal discharge.

Option A: Complete abortion is incorrect because it involves the complete expulsion of all products of conception from the uterus. The uterus is empty, and the cervix is closed.
Option B: Incomplete abortion is incorrect because it involves the partial expulsion of the products of conception. It is characterized by an open cervical os, persistent bleeding, and cramping.
Option D: Recurrent abortion (also known as recurrent pregnancy loss or habitual abortion) is a term used to describe a history of three or more consecutive spontaneous abortions. It is not a diagnosis for a single pregnancy event.

Visual 1: Diagram: A comparative chart illustrating the differences between threatened, inevitable, incomplete, complete, and missed abortion, showing the state of the fetus, uterus, and cervix for each.
Visual 2: Ultrasound Image: An example of a transvaginal ultrasound showing a gestational sac with a fetus but no detectable cardiac activity, confirming a missed abortion.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Types of spontaneous abortion (miscarriage) as background academic context rather than a clinical decision trigger.
A significant risk associated with prolonged retention of a dead fetus (typically more than 4 weeks) is the development of coagulopathy, specifically Disseminated Intravascular Coagulation (DIC), due to the release of thromboplastin from the degenerating placental tissue.
For Rh-negative women, the administration of Rh(D) immune globulin is crucial after any type of abortion to prevent isoimmunization in future pregnancies.
Nursing care for a patient with a missed abortion focuses on providing emotional support and clear information about management options, as the diagnosis can be emotionally devastating.

How to Approach the Question

First, analyze the question stem to identify the key clinical features described: a dead fetus that is retained inside the uterus for a few weeks.
Next, recall the definitions of the different types of spontaneous abortion provided in the options.
Evaluate 'Complete abortion': This involves the expulsion of all fetal tissue, which contradicts the 'retaining' aspect of the question.
Evaluate 'Incomplete abortion': This involves partial expulsion of tissue with an open cervix and bleeding, which doesn't match the typical presentation of a retained fetus with a closed cervix.
Evaluate 'Missed abortion': This term specifically describes a situation where the fetus has died but remains in the uterus with a closed cervix. This perfectly matches the scenario in the question.
Evaluate 'Recurrent abortion': This refers to a history of multiple losses, not the status of a single pregnancy. Therefore, it is not the correct answer for this specific event.

Concept Tested & Keywords

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