Lower Abdominal Cramping in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#10968
SMLE Question #10968
Obstetrics & Gynecology
General Gynecology
Objective: OBJ-ETH-STERIL
Last updated: February 2026
A 26-year-old G2P1 woman at 10 weeks’ gestation presents with lower abdominal cramping and vaginal bleeding that began today. She passed tissue 3 hours ago, after which bleeding decreased to mild spotting and pain resolved. She is Rh positive. An ultrasound 2 weeks ago confirmed an intrauterine pregnancy. Pelvic exam shows a closed cervical os and no heavy bleeding. Transvaginal ultrasound now shows an empty uterine cavity with no intrauterine gestational sac or obvious retained tissue. What is the most appropriate next step in management?
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