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Missed miscarriage — DRCOG MCQ

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HardEarly PregnancyMissed miscarriageDRCOG

A 28-year-old woman has a scan at 9 weeks after vaginal bleeding. It shows an intrauterine pregnancy with crown-rump length 23 mm and no fetal heartbeat. She is stable and wants to avoid surgery if possible. What is the most appropriate management?

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Correct answer: D — Offer expectant management for 7 to 14 days

NICE recommends expectant management for 7 to 14 days as first-line for confirmed miscarriage when clinically suitable and acceptable. Surgery may be chosen depending on symptoms, preference or risk, but it is not routine first-line here. Methotrexate is for selected ectopic pregnancies, not intrauterine miscarriage. The pearl is that patient preference and safety features guide the management route.

Reference: NICE NG126