A patient at 17 weeks gestation is diagnosed as having an intrauterine fetal demise. She returns to your clinic 5 weeks later and has not had a miscarriage, although she has had some occasional spotting. This patient isat increased risk for
A. Septic abortionB. recurrent abortion
C. Consumptive coagulopathy with hypofibrinogenemia
D. Ectopic pregnancies
The answer is c. In modern clinical medicine, once the diagnosis of fetal demise has been made, the products of conception are removed. If, however, the gestational age is over 14 weeks and the fetal death occurred 5 weeks ago, coagulation abnormalities may be seen. Septic abortions were more frequently seen during the era of illegal abortions, although occasionally sepsis can occur if there is incomplete evacuation of the products of conception in either a therapeutic or spontaneous abortion.
