Endovaginal ultrasound should be applied whenever possible to limit image distortion due to patient habitus or an overdistended bladder. Transabdominal ultrasound of the pelvis provides an overall view of the pelvic structures. A full bladder is required as a sonographic window. An empty bladder is preferred. Most patients abort spontaneously.
Coagulation defects secondary to a dead fetus are rare.
Expectant management or suction curettage may be performed. The uterus is emptied by dilatation and evacuation. Alternatively, the uterus is emptied by induction of labor. Transfer patients with evidence of a coagulation disorder to a higher level of care. Coagulation defects may be associated with a retained dead fetus.