Threatened miscarriage - need for ultrasound? | Figure 1
Threatened miscarriage - need for ultrasound?
HPI: 30yo pt, 17 weeks of pregnancy, comes to the ER complaining of recent onset of period-like vaginal bleeding, (20 min ago), referring bleeding appeared right after intercourse.
Had a previous episode of same characteristics 1 month ago which spontaneously solved.
H/ of unspecified vaginitis - not yet treated
Pelvic examination: external os open (1cm) internal closed. Light bleeding (dark color).
Managed expectantly (12-hour observation in ER). Normal vitals, No further vaginal bleeding after the first examination (only light brown spotting), never had abdominal pain.
Is this a threatened abortion or just cervical/vaginal trauma considering the intercourse factor and would you treat as an outpatient?
When would be the right timing to order a TV US?
Didn't find a fetal heartbeat with a handheld Doppler ultrasound device: would this finding be reliable considering that the pt is just 17 weeks pregnant?
Thanks