Question

A 22-year-old G1P0 woman presents to the emergency department at eight weeks gestation experiencing heavy vaginal bleeding. Pelvic examination demonstrates brisk bleeding through a dilated cervical os. The patient's hemoglobin is 7 g/dL (hematocrit 21%). Which of the following is the most appropriate next step in the management of this patient?

A. Administration of intravaginal misoprostol
B. Administration of oral misoprostol
C. Dilation and suction curettage
D. Endometrial ablation
E. Expectant care to permit spontaneous abortion

Answer 1

The most appropriate next step in the management of this patient is dilation and suction curettage to remove any retained products of conception and control the bleeding.

Step-by-step explanation:

The most appropriate next step in the management of this patient, a 22-year-old G1P0 woman presenting with heavy vaginal bleeding at eight weeks gestation, is C. Dilation and suction curettage. This is because she has a dilated cervical os and is experiencing brisk bleeding, indicating a possible miscarriage or incomplete abortion. Dilation and suction curettage is the most effective and expedient method to remove any retained products of conception and control the bleeding.