Acute Lower Abdominal Cramping in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#1563
SMLE Question #1563
Obstetrics & Gynecology
General Gynecology
Objective: OBJ-ETH-STERIL
Last updated: February 2026
A 26-year-old G2P1 woman at 10 weeks’ gestation presents with acute lower abdominal cramping and vaginal bleeding. She reports passing tissue 3 hours ago, followed by marked reduction in bleeding. A dating ultrasound at 7 weeks confirmed an intrauterine pregnancy. Speculum examination shows a small amount of blood in the vault; the cervical os is closed with no tissue seen. Transvaginal ultrasound shows no gestational sac and no obvious retained tissue. She is Rh-negative and has received anti-D immunoglobulin. What is the most appropriate next step in management?
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