Inevitable abortion means that a miscarriage is destined to occur, but no tissue has yet been passed.

This is sometimes called a “missed abortion.”

This diagnosis is best made by ultrasonic visualization of the fetal heart and noting no movement. Alternatively, demonstrating no growth of the fetus over a one week period in early pregnancy confirms an inevitable abortion. Falling levels of HCG are an ominous sign and strongly suggest the pregnancy is no longer living.

Two alternative approaches are considered for an inevitable abortion: Surgical removal of the pregnancy or awaiting a spontaneous abortion. Each approach has its own merits and limitations:

Awaiting a spontaneous abortion offers the benefit of avoiding surgery, but commits the patient to a day or more of heavy bleeding and cramping. A few of these women will experience an incomplete abortion and will need to have a D&C anyway.

Performing a D&C has the benefit of quickly resolving the issue of a missed abortion, but commits the patient to a surgical procedure which carries some risks.