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Incomplete miscarriage — DRCOG MCQ

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HardEarly PregnancyIncomplete miscarriageDRCOG

A 22-year-old woman at 10 weeks has heavy bleeding, open cervix and retained tissue on ultrasound. What is the most appropriate management?

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Correct answer: CDiscuss expectant, medical and surgical management options

The best answer is “Discuss expectant, medical and surgical management options”. Discuss expectant, medical and surgical management options is the best answer because the vignette is testing Incomplete miscarriage and the recommended approach is consistent with NICE NG126. The other Specifically, Advise oral analgesia and routine follow-up, Refer for routine gynaecology review, Advise rest and hydration at home, Offer empirical antifungal treatment would be suboptimal in this scenario. In DRCOG-style primary care questions, the safest answer is usually the step that matches the acuity and gestation rather than symptomatic treatment alone. Antenatal decisions combine gestation, maternal stability, fetal risk and whether care can safely remain in the community. Screening, diagnostic testing and urgent assessment are not interchangeable. The UK pathway should be followed with clear safety-netting whenever symptoms may evolve before the next routine appointment.

Reference: NICE NG201: Antenatal care: https://www.nice.org.uk/guidance/ng201/chapter/recommendations