Spontaneous abortion with MRI correlates in the emergency department

Spontaneous abortions are associated with 20 percent of all pregnancies and they are the most common cause of first trimester bleeding. Diagnosis is based on ultrasound findings. Patients typically present with vaginal bleeding and severe lower abdominal pain. We report a 25 year old female with vaginal bleeding, bilateral abdominal pain, and normal transvaginal US findings on admission. Follow-up magnetic resonance imaging in the emergency department demonstrated heterogeneous, T2 isointense/hyperintense signal material extending from the uterine cavity and protruding into the vaginal canal, consistent with active passage of products of conception. Findings were confirmed by pathology and speculum exam.