Differential Diagnosis for 39-year-old Female Status Post Miscarriage

Single Most Likely Diagnosis

• Retained Products of Conception (RPOC): This condition is highly likely given the patient's recent miscarriage without a D&C, presenting with cramps and black blood, which suggests incomplete expulsion of the products of conception.

Other Likely Diagnoses

• Infection: Although the patient denies fever, infection is still a possibility, especially if there are retained products of conception. The presence of cramps and abnormal bleeding supports this diagnosis.
• Hormonal Changes: Post-miscarriage hormonal fluctuations can cause cramping and irregular bleeding, making this a plausible diagnosis.

Do Not Miss Diagnoses

• Septic Abortion: Although the patient denies fever, septic abortion is a life-threatening condition that must be considered, especially if there was an attempt to induce the miscarriage or if the miscarriage was incomplete.
• Disseminated Intravascular Coagulation (DIC): This is a rare but potentially fatal complication of retained products of conception or septic abortion, characterized by widespread clotting and bleeding.

Rare Diagnoses

• Molar Pregnancy: Although rare, a molar pregnancy could present with abnormal bleeding and cramping after a miscarriage, especially if the initial pregnancy was not properly evaluated.
• Uterine Atony: This condition, characterized by the failure of the uterus to contract after a miscarriage, can lead to severe bleeding and is a rare but potential cause of the patient's symptoms.