Statistics from Altmetric.com
A 21-year-old woman gravida 3 para 1, about 8 weeks pregnant, presents with lower abdominal pain. She describes the pain as crampy and intermittent associated with mild vaginal bleeding. On physical exam her blood pressure is 120/60 and her heart rate is 75, with mild bilateral lower abdominal tenderness to deep palpation. Labs are currently pending, including a quantitative β-hCG, which is a 4 h send out. Urinalysis shows seven white blood cells, three red blood cells and two epithelial cells with 1+ leucocyte esterase and no nitrates. You decide to perform a transabdominal and transvaginal ultrasound. The patient has had her left ovary removed in the past due to a haemorrhagic cyst and therefore left adnexal pictures are not included.
What is your interpretation of the ultrasound images?
How would the quantitative β-hCG alter your interpretation?
What is the appropriate disposition for this patient?
1. The first image (A) is the …
Competing interests None.
Provenance and peer review Commissioned; internally peer reviewed.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.