Retained products of conception with a thick complex endometrium and a gestational sac containing a nonviable embryo, with abnormally rising HCG describes which condition?

• A. Incomplete abortion
• B. Heterotopic pregnancy
• C. Ectopic pregnancy
• D. Pseudocyesis

Answer: (A)

When a pregnancy loss leaves tissue behind in the uterus, ultrasound often shows thick, complex endometrium with retained products of conception. If there’s a gestational sac inside the uterus that contains a nonviable embryo, this means the pregnancy stopped developing but tissue was not fully expelled. That scenario fits incomplete abortion: some products have been expelled, but residual tissue remains, sustaining ongoing, abnormal hormonal activity (HCG not falling as expected and can even rise) because the remaining trophoblastic tissue continues to produce HCG.

In contrast, complete abortion would show no intrauterine gestation and HCG would fall to undetectable levels; ectopic pregnancy would reveal an extrauterine gestational sac outside the uterus; heterotopic would show both intrauterine and ectopic pregnancies; pseudocyesis involves no real pregnancy and minimal or no HCG elevation.