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Missed abortion with negative biomarkers
Robert Allen1, Allison Lee1, Christopher Hanuscin1
1Department of Emergency Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA; Department of Emergency Medicine, Kings County Hospital Center, Brooklyn, NY, USA.
The American Journal of Emergency Medicine
|April 30, 2022
Summary
Even with negative urine and serum pregnancy tests, women experiencing vaginal bleeding may have retained fetal products. Ultrasonography can confirm pregnancy complications when initial tests are inconclusive, guiding appropriate medical intervention.
Area of Science:
- Obstetrics and Gynecology
- Emergency Medicine
- Diagnostic Imaging
Background:
- First-trimester bleeding and pregnancy loss are frequent reasons for emergency department visits.
- Urine and serum pregnancy tests are commonly used and generally reliable markers of pregnancy in women of childbearing age.
Observation:
- A 34-year-old woman presented with vaginal bleeding and abdominal pain.
- Initial urine and serum pregnancy tests were negative.
- Transvaginal ultrasound revealed non-viable fetal tissue.
Findings:
- The patient experienced a spontaneous abortion despite negative pregnancy markers.
- Ultrasonography identified retained fetal products when biochemical tests were unrevealing.
Implications:
- Physicians should consider ultrasonography in patients with suspected pregnancy complications, even with negative serum or urine pregnancy tests.
- This case highlights the importance of imaging in diagnosing pregnancy-related issues when biochemical markers are inconclusive.
- Timely ultrasound assessment can lead to appropriate management of spontaneous abortion and retained products of conception.
