The scenario:
A 26-year-old (she/her) presents to your health center four weeks after a medication abortion at eight weeks of gestation. She reports bleeding was initially heavy with blood clots, and is now lighter, but she continues to have intermittent light bleeding and mild cramping. She reports she believes she is not pregnant anymore, as pregnancy symptoms have resolved, but is not sure if things are “done.”
A transvaginal ultrasound shows a heterogeneous collection and thickened endometrial stripe, without a persistent gestational sac or evidence of an ongoing pregnancy.
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