Early pregnancy loss Quiz: Ace Your Exams

Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!

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A 32-year-old woman, gravida 4, para 3, at 10 weeks of gestational age presents to the emergency department at noon with heavy vaginal bleeding and severe pelvic pain. This morning, she soaked through four pads in an hour and passed multiple large clots, some of which appeared to contain tissue—though she has been using the same pad for the past two hours. The pain is currently rated a 5 on a 10-point scale, though at its peak, it was a 9 and radiated to her lower back and thighs. An ultrasound performed two weeks ago showed a viable fetus with cardiac activity. The medical history is notable for three prior uncomplicated vaginal deliveries. Temperature is 36.6°C (97.9°F), pulse is 76/min, respirations are 16/min, and blood pressure is 122/78 mmHg. On exam, the cervical os is closed and several small blood clots are visible in the vagina. Lab results are shown below. An ultrasound shows a thickened endometrial lining without an intrauterine fluid collection; the adnexa appear grossly normal. IV fluids and analgesics are administered. What is the most appropriate next step in management? 

 Laboratory test     Result     Reference range    
 Blood type     A-negative     Not applicable    
 Hemoglobin     10.8 g/dL     12-16 g/dL    
 Platelets     304,000/mm3     150,000-400,000/mm3    
 Prothrombin time     12 sec     11-15 sec    
 Activated partial thromboplastin time     30 sec     25-40 sec    

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