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First-trimester bleeding — CCFP MCQ

Instant feedback + full explanation. One question, done properly.

HardWomen's health/OB/GYNFirst-trimester bleedingCCFP

A 29-year-old at an estimated 7 weeks’ gestation has light vaginal bleeding but is hemodynamically stable and has no significant pain. Transvaginal ultrasound shows an intrauterine gestational sac measuring 14 mm with a yolk sac but no embryo. What is the appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Repeat transvaginal ultrasound after an interval before diagnosis

Explanation lettering: B = shown as A · E = shown as B · A = shown as E

C is correct. This ultrasound does not meet Canadian diagnostic criteria for nonviability: a gestational sac without an embryo requires a mean sac diameter of at least 25 mm to diagnose pregnancy loss. D is inappropriate with a confirmed intrauterine pregnancy and no evidence of ectopic pregnancy. E and A could end a potentially viable pregnancy. B is also unsafe because early pregnancy loss remains possible. Give clear safety-net advice for pain, heavy bleeding or syncope while arranging follow-up.

Reference: Society of Obstetricians and Gynaecologists of Canada: Pregnancy Loss Hub for health-care providers: https://www.sogc.org/en/content/events/HUB-Pages/pregnancy-loss-for-health-care-providers.aspx