A 20-year-old woman complains of sudden onset of right-sided lower abdominal pain and bleeding per vagina. Her last normal menstrual period was 35 days ago. Her blood pressure is 90/70 mmHg and the pulse rate is 100 bpm. There is tenderness and guarding in the right iliac fossa. She denies any sexual intercourse.What is the most appropriate next step in the management?
Ans. is d, i.e. Perform a transvaginal ultrasound scanIn this patient:Rt sided lower abdominal pain with bleeding per vagina and amenorrhea: Indicate ectopic pregnancy. This is further supported by tenderness and guarding of Rt iliac fossaB/P=90/70mmP/R=100bpm ]Vitalsarestable[?] Next step is to do TVS, i.e. transvaginal ultrasound scan to confirm the diagnosis.
Estimate serum beta hCG levels
Obtain a surgical opinion to exclude acute appendicitis
Perform a laparoscopic examination
Perform a transvaginal ultrasound scan
Ecotopic Pregnancy