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1. Mrs X presented to the A&E with history of vaginal bleeding & lower abdominal pain. Pregnancy test was positive. An ultrasound was ordered & the sonologist called back saying ,she was suapecting a cervical pregnancy. All of the features below except one,when considered together would suggest a cervical ectopic,Which feature would not be suggestive of a cervical ectopic pregnancy?
2. A primi with 6 weeks amenorrhea presented to the A & E with mild vaginal bleeding. A pregnancy test done at home was positive. The lady was scared that she was having a miscarriage & wanted a scan to know how the pregnancy was progressing. The lady was clinically stable. A TVS was done which showed a normal size anteverted uterus with thickened endometrium. Both ovaries & tubes were normal & there was no free fluid in Pouch of Douglas. A BHCG was ordered which was 200.So she was called again after 48 hrs & repeat BHCG was 400. What will you explain to the lady regarding the prognosis for this pregnancy
3. A 35 year old multiparous lady presents to the A & E with a one week history of brownish vaginal discharge. She is not sure of her last menstrual period & she is not on any contraception. A pregnancy test was positive. A TVS showed a complex right adnexal mass,measuring15x10x10 mm & no free fluid in POD. The uterus was empty. BHCG done measured 500iu/L. The patient was clinically stable. Taking into consideration the scan findings & a positive BHCG. She was diagnosed as a case of right ectopic pregnancy. What is the treatment of choice for her?
4. A 22 year old woman experiences mild bleeding at 7 weeks of gestation. She attends the EPAU ,where a TVS is done. It shows a gestational sac with a diameter of 20 mm & no fetal pole. What is the next step in your management?
5. A 40 year old woman had a complete hydatidiform mole evacuated uneventfully. Post evacuation the BHCG dropped to 1000 iu/L from a level of 50,000iu/L. It remained at 1000 iu/L for 8 weeks post evacuation. Clinical exam & investigations showed no evidence of metastasis. A tvs showed a 2 cm lesion in the myometrium. What is the further management in this case?
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