Author: William Wilson, Ulrike Jacobs / Editor: Nick Tilbury / Codes: ObC1, ObC2, ObP1, ObP2, ObP3, SLO1, SLO2, SLO3 / Published: 13/10/2023
A 27-year-old lady at gestational age of 12 weeks (G2P1L1) presents to the Emergency Department (ED) with complaints of vaginal spotting for two days.
She tells you the bleeding has slowly worsened over the last two days and she has now started passing some clots. The bleeding is associated with cramping lower abdominal pain. She denies any nausea, vomiting, bowel or bladder change and has not experienced similar symptoms during previous pregnancies.
Her observations are as follows:
- HR – 44
- BP 72/46
- RR – 26
- SpO2 – 99 o/a
- Temperature – 37.2
On examination you note she is cool and clammy and looks unwell.
She has a normal abdominal contour, her abdomen is not distended but is mildly tender on deep palpation in the suprapubic region. Bowel sounds are normal and there is no guarding or rigidity.
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Question 1 of 2
1. Question
Based on the clinical information available, which of the following should be on the list of differential diagnoses?
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Question 2 of 2
2. Question
At this point you do a speculum examination, which reveals no active bleeding, but you can see products of conception stuck at the cervical os.
Bloods are done, including a venous blood gas, which shows the following:
- pH 7.41
- PCO2 5.5
- HCO3 25
- Lactate 0.9
- Hb 140
While the VBG was being processed, a litre of Hartmann’s had been given via a pressure bag and a repeat set of observations are now done:
- HR 44
- BP 78/48
- RR 25
- SpO2 99 o/a
- Temp 37.2
Based on the clinical information available, which of the following should now be on the list of differential diagnoses?
CorrectIncorrect
Module Content
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