What are the main findings on these focused views of the cervix?
Open cervix with fetal parts present in the cervical canal.
What are the two differentials to be considered, and which is more likely?
The differential for fetal parts within the cervical canal includes cervical ectopic or miscarriage in progress. The lack of a distinct gestational sac within the open cervix favours miscarriage. Absence of fetal cardiac activity supports this (although this could also be seen in a non-viable cervical ectopic).
How could this be confirmed?
Completion of miscarriage or change in the appearance and location on the gestational sac should be seen on subsequent imaging.
The cervix is open, and a 9 week old fetus is seen within the lower uterine segment. There was no fetal cardiac activity (cardiac trace not shown).