A 32-year-old woman presents with vaginal bleeding at 12 weeks of gestation. She reports she has been feeling severe cramping. On examination, the cervix is dilated. What could be the potential diagnosis, and what are the next steps?
This woman's presentation suggests a miscarriage, specifically an incomplete miscarriage given the ongoing vaginal bleeding, cramping, and dilated cervix. An ultrasound should be performed to further evaluate the status of the pregnancy. If the diagnosis of incomplete miscarriage is confirmed, management options would depend on the patient's clinical status and could include expectant management, medical management with misoprostol, or surgical management with dilation and curettage (D&C).