A complete miscarriage is defined as a cessation of vaginal bleeding with no evidence of retained products of conception or a gestation sac in a woman who previously had an ultrasound confirmed intrauterine pregnancy.
Shows an empty uterus with no fetal components or products of conception.
In the setting of a positive bHCG, the differential for an empty uterus is:
- complete miscarriage
- ectopic pregnancy
- pregnancy too early to be detected
- pregnancy of unknown location
The diagnosis of a complete miscarriage can be confidently made only if there is a documented intrauterine pregnancy. If there had been no prior ultrasound of this pregnancy, the situation is referred to as pregnancy of unknown location and followed up accordingly.
Once complete miscarriage is confirmed, no active management is required unless there is prolonged bleeding for greater than four weeks.