house officer: this lady claimed passed out product of conception at home, but did not bring. but scan today fetal heart is positive, shown to her. now, totally no more per vaginal bleeding.
me: so, what could possibly be the diagnosis?
HO: incomplete miscarriage.
me: that's like half already came out, will the heart still be beating?
me: OK, let just imagine a part of you being chop to half and i took away your lower half, will your heart still be beating? I think you really watch too many magic shows or cartoon.
HO: oh, so it's threatened miscarriage.
me: yes (thinking: unless it is a miracle.)
Technically-speaking, if there was not any prior scan showing a singleton, distantly rarely possible, it can still be a possibility of complete miscarriage of a first twin and threatened of the remaining one. But I shall not cross into the unfamiliar territory with the juniors. Not today.