Retained products: thick and vascular

Question 1Which finding favours retained products over clot?

1. aA thin endometrial line
2. bBlood flow on colour Doppler within a thick, uneven endometrium
3. cComplete absence of flow
4. dFree fluid alone

Question 2Is endometrial thickness alone enough to diagnose retained products?

1. aThickness is never measured
2. bYes, anything over 2 mm is diagnostic
3. cNo, because no single thickness cut-off is reliable
4. dYes, anything over 5 mm is diagnostic

Question 3A woman with retained products after a miscarriage has fever and an offensive discharge. What next?

1. aRepeat the scan in a month
2. bTreat as an infected miscarriage: urgent antibiotics and gynaecology review
3. cReassure: this is normal
4. dDischarge with analgesia

Question 4A patient is bleeding heavily and is hypotensive after a miscarriage. What comes first?

1. aA detailed transvaginal scan
2. bResuscitation and urgent gynaecology review
3. cAn hCG measurement before anything else
4. dA formal radiology appointment

Question 5Strong flow in the uterine wall persists and the hCG stays high. What else should you consider?

1. aA vascular malformation or trophoblastic disease
2. bA normal finding which needs no follow-up
3. cClot
4. dA simple ovarian cyst