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Hemorrhage after medication abortion — USMLE Step 3 MCQ

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HardOB/GYNHemorrhage after medication abortionUSMLE Step 3

A 35-year-old woman develops heavy vaginal bleeding and severe cramping 2 hours after medication abortion at 8 weeks' gestation. She is pale, blood pressure is 86/52 mm Hg, pulse is 128/min, and ultrasound shows echogenic intrauterine material. Hemoglobin has fallen from 12.4 to 9.2 g/dL. Which of the following is the most likely explanation for this patient's findings?

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Correct answer: B — Retained products causing hemorrhage

Hemodynamic instability, heavy bleeding, hemoglobin drop, and intrauterine echogenic material after medication abortion suggest retained products of conception causing hemorrhage and require urgent uterine evacuation and resuscitation.

Reference: ACOG medication abortion and early pregnancy loss guidance