Which of the following is NOT a characteristic of a threatened abortion?

BTSC Staff Nurse 30July-2025

Obstetrics & Gynaecology

Easy

Appeared in: BTSC Staff Nurse 30July-2025

Explanation

The defining characteristic of a threatened abortion is a closed internal cervical os. An open cervix signifies that the abortion has progressed to an inevitable or incomplete stage, where the loss of the pregnancy is certain or has already partially occurred.
While vaginal bleeding and cramping are symptoms of a threatened abortion, the cervix remains closed, and the pregnancy is still viable.
Therefore, an 'Open cervix' is not a characteristic of a threatened abortion; it is the key sign that differentiates it from one.

Option A: Vaginal bleeding, ranging from spotting to more significant flow, is the hallmark presenting symptom of a threatened abortion.
Option B: Mild, menstrual-like uterine cramping or a feeling of pelvic pressure often accompanies the vaginal bleeding in a threatened abortion.
Option D: By definition, a threatened abortion involves a pregnancy that is still viable, meaning a live fetus with cardiac activity is confirmed by ultrasound. If the fetus were not viable, it would be classified as a missed abortion or embryonic demise.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Differentiating features of threatened abortion from other types of spontaneous abortion as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in assessing a patient with first-trimester bleeding. Key assessments include the amount and character of bleeding, the severity of pain, and asking if any tissue has been passed. This information is vital for the physician to differentiate the type of abortion.
Providing emotional support is a key nursing intervention. The uncertainty of a threatened abortion is very stressful for the patient and her family.
Patient education includes advising pelvic rest (no intercourse) and instructing the patient to report any increase in bleeding, severe pain, or passage of tissue, as these are signs of progression to an inevitable or incomplete abortion.

How to Approach the Question

First, identify the core concept of the question, which is 'threatened abortion'.
Second, notice the negative keyword 'NOT'. This signals that you must find the option that is inconsistent with the diagnosis of a threatened abortion.
Third, recall the classic definition of a threatened abortion: vaginal bleeding before 20 weeks of gestation, with a viable fetus, and, most importantly, a closed cervix.
Fourth, evaluate each option against this definition:
Vaginal bleeding? Yes, this is a symptom.
Uterine cramping? Yes, this is a possible symptom.

Concept Tested & Keywords

Concept Tested: Differentiating features of threatened abortion from other types of spontaneous abortion.
Stem keywords: threatened abortion, characteristic
Lead-in keywords: NOT
Negative lead-in flag: The question asks for the feature that is NOT characteristic of a threatened abortion.

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E6 Gynecology Williams pp. 148-179, 147-178

E6 Obstetrics Williams p. 90-95