Missed abortion with negative biomarkers

BACKGROUNDFirst-trimester bleeding and pregnancy loss are common reasons for presentation to emergency departments. Women of childbearing age frequently receive urine and serum pregnancy tests, which are thought to be reliable markers of pregnancy. CASE PRESENTATIONWe report a case of a 34-year-old woman who presented to an emergency department with vaginal bleeding and abdominal pain and was found to have negative urine and serum markers of pregnancy. A transvaginal ultrasound detected non-viable fetal tissue and the patient underwent an uncomplicated spontaneous abortion. CONCLUSIONSPhysicians should consider the use of ultrasonography to assess for pregnancy or retained fetal products in the appropriate patient, even with negative serum or urine markers of pregnancy.