Shock in the First Trimester

Based on the clinical information available, which of the following should be on the list of differential diagnoses?

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?