Inevitable miscarriage refers to the presence of an open internal os in the presence of bleeding in the first trimester of pregnancy. Most often the conception products are not expelled and intracervical contents are present at the time of examination. A sac may be seen low within the uterus and progressive migration of the same may be demonstrated on serial scans.
Essentially, a threatened miscarriage progresses to an inevitable miscarriage if cervical dilatation occurs. Once tissue has passed through the cervical os, this will then be termed an incomplete miscarriage, and ultimately a complete miscarriage.
Cervical ectopic pregnancy is a rare but potentially catastrophic differential that should be excluded by means of a repeat ultrasound and serial beta hCG. If cervical ectopic is not considered as a differential for a gestational sac in the endocervix, curettage of a presumed incomplete miscarriage may result in unexpected severe hemorrhage.
- 1. Falco P, Zagonari S, Gabrielli S et-al. Sonography of pregnancies with first-trimester bleeding and a small intrauterine gestational sac without a demonstrable embryo. Ultrasound Obstet Gynecol. 2003;21 (1): 62-5. doi:10.1002/uog.2 - Pubmed citation
- 2.Brant WE, Helms CA. Fundamentals of diagnostic radiology. Lippincott Williams & Wilkins. (2007) ISBN:0781761352. Read it at Google Books - Find it at Amazon
- 3. Smith NC, Smith AP. Obstetric and gynaecological ultrasound made easy. Elsevier Health Sciences. (2005) ISBN:0443100551. Read it at Google Books - Find it at Amazon
Related Radiopaedia articles
First trimester of pregnancy
- ultrasound findings in early pregnancy
- confirming intrauterine gestation
- pregnancy of unknown location (PUL)
first trimester vaginal bleeding
- ectopic pregnancy
failed early pregnancy
- pregnancy of uncertain viability (PUV)
- anembryonic pregnancy
- yolk sac abnormalities
- gestational trophoblastic disease
- subchorionic hemorrhage
- demise of a twin
- implantation bleeding
- early structural scan
- aneuploidy testing