A 27-year-old G1P0 at 12 weeks gestation presents with painless vaginal bleeding and a closed cervical os. What is the most likely diagnosis?

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Multiple Choice

A 27-year-old G1P0 at 12 weeks gestation presents with painless vaginal bleeding and a closed cervical os. What is the most likely diagnosis?

Explanation:
Vaginal bleeding in the first trimester with a closed cervix signals a threatened abortion. Here, the pregnancy is still intrauterine and potentially viable because there is bleeding without dilation of the cervix or passage of products. This distinguishes it from inevitable abortion, where the cervix dilates and tissue begins to pass; from incomplete abortion, where some products have been expelled and the cervix is open; and from complete abortion, where all products are expelled and the uterus subsequently closes. In a 12-week pregnancy with painless bleeding and a closed os, threatened abortion is the most likely scenario. Management centers on confirming ongoing viability with ultrasound, monitoring, and providing counseling and precautions, with attention to Rh status if appropriate. If cervical dilation or tissue passage occurs, the diagnosis would change accordingly.

Vaginal bleeding in the first trimester with a closed cervix signals a threatened abortion. Here, the pregnancy is still intrauterine and potentially viable because there is bleeding without dilation of the cervix or passage of products. This distinguishes it from inevitable abortion, where the cervix dilates and tissue begins to pass; from incomplete abortion, where some products have been expelled and the cervix is open; and from complete abortion, where all products are expelled and the uterus subsequently closes. In a 12-week pregnancy with painless bleeding and a closed os, threatened abortion is the most likely scenario. Management centers on confirming ongoing viability with ultrasound, monitoring, and providing counseling and precautions, with attention to Rh status if appropriate. If cervical dilation or tissue passage occurs, the diagnosis would change accordingly.

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