With an incomplete abortion, some tissue remains behind inside the uterus.
These patients typically present with continuing bleeding, sometimes very heavy, and sporadic passing of small pieces of pregnancy tissue.
![Incomplete Abortion 1 Incomplete Abortion](https://brooksidepress.org/mil_ob_gyn/wp-content/uploads/2015/06/incab1-225x300.jpg)
Ultrasound may reveal the presence of identifiable tissue within the uterus. Serial quantitative HCG levels can be measured if there is doubt about the completeness of a miscarriage.
Left alone, many of these cases of incomplete abortion will eventually resolve spontaneously, but so long as there are non-viable pieces of tissue inside the uterus, the risks of bleeding and infection continue.
Treatment consists of converting an incomplete abortion into a complete abortion. Usually, this is done with a D&C (dilatation and curettage). This minor operation can be performed under local anesthesia and takes just a few minutes.
Alternatively, bedrest and oxytocin, 20 units (1 amp) in 1 Liter of any crystalloid IV fluid at 125 cc/hour may help the uterus contract and expel the remainder of the pregnancy tissue, converting the incomplete abortion to a complete abortion.
Alternatively, ergonovine 0.2 mg P.O. or IM three times daily for a few days may be effective.
If fever is present, broad-spectrum antibiotics are wise.
Rhogam is given to rH negative women.
Any tissue fragments visibly protruding from the cervical os can be grasped with a ring or dressing forceps and gently pulled straight out. This simple and safe procedure will have a beneficial effect on the bleeding.