When a fetus dies and is retained in the uterus, it is called?

Appeared in: HPSSC - 2015

Explanation

A missed abortion is defined as a pregnancy in which fetal demise has occurred, but the products of conception are retained within the uterus.
The term was historically used when the fetus was retained for several weeks or months, but with modern ultrasound, the diagnosis is made much sooner.
Clinically, the cervix is closed, and the uterus may be smaller than expected for the gestational age.
Symptoms like bleeding are often absent or present only as a scant, brownish discharge.

Why Other Options Were Wrong

Option A: Inevitable abortion involves an open cervical os, indicating that the expulsion of the products of conception is imminent or in progress. In a missed abortion, the cervix is closed.
Option C: Complete abortion means that all products of conception (fetus and placenta) have been expelled from the uterus. The question states the fetus is retained.
Option D: Threatened abortion refers to vaginal bleeding during early pregnancy while the fetus is still alive and the cervical os is closed. The question specifies that the fetus has died.

Related Visual

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Types of spontaneous abortion as background academic context rather than a clinical decision trigger.
Nurses must monitor patients with a missed abortion for signs of infection (fever, abdominal pain, foul-smelling discharge) and coagulopathy, such as disseminated intravascular coagulation (DIC), which is a risk if the products are retained for more than 4 weeks.
Management options include expectant management, medical management with misoprostol, or surgical evacuation (D&C). The nurse's role includes patient education on these options, providing emotional support, and managing care based on the chosen method.
It is crucial to assess the patient's Rh status. If the patient is Rh-negative, Rho(D) immune globulin must be administered to prevent isoimmunization in future pregnancies.

How to Approach the Question

First, identify the key phrases in the question: "fetus dies" and "retained in the uterus."
Next, recall the definitions of the different types of spontaneous abortion provided in the options.
Threatened abortion: bleeding with a live fetus and closed cervix.
Inevitable abortion: bleeding with a dilated cervix, making loss unavoidable.
Complete abortion: all products of conception are expelled.
Missed abortion: fetal death occurs, but the products are retained in the uterus with a closed cervix.

Concept Tested & Keywords

Concept Tested: Types of spontaneous abortion
Stem keywords: fetus dies, retained in the uterus
Lead-in keywords: is called
Negative lead-in flag: false

Question ID

QMM919pP2yXxiHlvo_CkJS

Reference Book

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 8397-8399

E6 Gynecology Williams p. 152-181

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