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Updated: Sep 25, 2025

Author Spotlight: Advancing Reproductive Immunology with a Protocol for the Quantitative Evaluation of Endometrial Immune Cells
Published on: October 13, 2023
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.
Background:
First-trimester bleeding and pregnancy loss are common reasons for presentation to emergency departments. Women of childbearing age frequently receive urine and serum pregnancy tests, which are thought to be reliable markers of pregnancy.
Case Presentation:
We report a case of a 34-year-old woman who presented to an emergency department with vaginal bleeding and abdominal pain and was found to have negative urine and serum markers of pregnancy. A transvaginal ultrasound detected non-viable fetal tissue and the patient underwent an uncomplicated spontaneous abortion.
Conclusions:
Physicians should consider the use of ultrasonography to assess for pregnancy or retained fetal products in the appropriate patient, even with negative serum or urine markers of pregnancy.

