A patient experiences vaginal bleeding with pain and cervical dilation at 3 cm. What is the most likely diagnosis?

The scenario describes a patient with vaginal bleeding, pain, and cervical dilation at 3 cm, which closely aligns with the characteristics of an inevitable abortion. In such cases, the presence of cervical dilation indicates that the body is beginning the process of expelling the contents of the uterus, and the accompanying bleeding and pain further support this diagnosis.

Inevitable abortion is characterized by the combination of these clinical signs—especially the cervical dilation—indicating that a miscarriage is imminent and cannot be prevented. This contrasts with other types of abortion where the criteria differ: for example, a threatened abortion includes vaginal bleeding but with a closed cervix and without significant pain, indicating that the pregnancy may still continue. In cases of incomplete abortion, the cervix would be open but the pregnancy tissue has already been partially expelled. Acute pelvic inflammatory disease typically presents with different symptoms such as fever, pelvic pain, and possibly abnormal vaginal discharge, not just bleeding and cervical dilation.

Therefore, identifying the context of the symptoms and the state of the cervix confirms that inevitable abortion is the correct diagnosis in this case.