A 20-year-old woman presents with a positive pregnancy test and is diagnosed with an ectopic pregnancy after ruling out an intrauterine pregnancy. She is asymptomatic and her serum beta-human chorionic gonadotropin (B-hCG) level is 877 IU/L. A transvaginal ultrasound shows a 24mm adnexal mass without a heartbeat and no free fluid in the abdomen. Although expectant management is an option, she declines. What is the recommended initial treatment?
A 35-year-old primigravida woman, at 10 weeks gestation, presents to the emergency department with heavy vaginal bleeding. She reports passing large clots and experiencing cramping for the past 2 hours.
Upon examination, her blood pressure is 85/60 mmHg and her heart rate is 120 beats/minute. Pelvic examination reveals blood clots in the vaginal canal. A speculum exam shows active vaginal bleeding, a dilated cervical os, and a uterus consistent in size with a 9-week gestation. Pelvic ultrasonography reveals small amounts of fluid in the endometrium with an intrauterine sac measuring 22mm in crown-rump length, but no fetal cardiac activity is detected.
What is the most appropriate next step in management?
A 35-year-old woman comes in for a routine antenatal check-up at 20 weeks gestation. This is her first pregnancy and she has had no complications thus far. She has no significant medical history and does not take any regular medications. She is a non-smoker and does not consume alcohol. During her visit, her blood pressure is measured at 150/94 mmHg, which is higher than her previous readings in early pregnancy. Upon examination, there is no edema and her reflexes are normal. Urinalysis shows no protein, blood, leukocytes, glucose, or nitrites. What is the most appropriate course of action?
A 25-year-old female patient visits her GP complaining of abdominal pain and a positive pregnancy test, despite having an intrauterine system. She is urgently referred to the emergency department where an ultrasound scan confirms a tubal ectopic pregnancy with a visible heartbeat. The patient has never been pregnant before but desires to have a family in the future. There is no history of sexually transmitted infections. What is the best course of action for management?
A 35-year-old woman, para 2+0, is currently in the second stage of labour and has successfully delivered the anterior shoulder. She has chosen active management for the third stage of labour. During her pregnancy, she experienced mild gestational hypertension and her most recent blood pressure reading was 140/90 mmHg. What medication should be given at this point?
A 35-year-old woman presents with a significant obstetric hemorrhage due to uterine atony. What is the initial medical management after stabilization and general measures?
A 28-year-old primigravida patient presents to the emergency department with a 3-day history of light per-vaginal spotting. Based on her last menstrual period date, she is 8 weeks and 4 days gestation and has not yet undergone any scans. She reports no abdominal pain or flooding episodes and has no prior medical history. A transvaginal ultrasound scan reveals a closed cervical os with a single intrauterine gestational sac, a 2 mm yolk sac, and a crown-rump length measuring 7.8mm, without cardiac activity. What is the most probable diagnosis for this patient?
A 26-year-old female patient visits her GP complaining of vaginal bleeding. She is currently 6 weeks pregnant and denies experiencing any abdominal pain, dizziness, or shoulder tip pain. She reports passing less than a teaspoon of blood without any clots. The patient has no history of ectopic pregnancy. During examination, her heart rate is 85 beats per minute, blood pressure is 130/80 mmHg, and her abdomen is soft and non-tender. As per the current NICE CKS guidelines, what is the next appropriate step in managing this patient?
You are assessing a pregnant woman who is currently 30 weeks along with her second child. Her first child, who is now 3 years old, had neonatal sepsis caused by Group B Streptococcus (GBS). The patient is inquiring about measures that can be taken to prevent a recurrence of this in her current pregnancy. What treatment will be necessary for the patient and/or baby?
A woman in her 12th week of pregnancy arrives at the emergency department with a two-week history of intense vomiting and lack of appetite. The scent of food triggers her nausea. She hasn’t consumed any food for the past four days and has only had minimal amounts of water.
She is currently taking omeprazole and folic acid and has never smoked or consumed alcohol. What is an instance of a risk factor for this ailment?