CASE # 5

ECTOPIC PREGNANCY

A 19-year-old G2P0 woman at 7 weeks gestation by last menstrual period complains of vaginal spotting.
She denies the passage of tissue per vagina, any trauma, or recent intercourse. Her past medical history
is significant for a pelvic infection approximately 3 years ago. She had used an oral contraceptive agent 1
year previously. Her appetite is normal. On examination her blood pressure is 100/60mmHg, her heart
rate is 90 beats per minute (bpm) and temperature is afebrile. The abdomen is nontender with
normoactive bowel sounds. On pelvic examination, the external genitals are normal. The cervix is closed
and nontender. The uterus is 4 week's size and no adnexal tenderness is noted. The quantitative beta
human chorionic gonadotropin is 2300 mIU/mL. A transvaginal sonogram reveals an empty uterus and
no adnexal masses.

CASE # 6

PLACENTA PREVIA

A 30-year-old G5P4 woman at 32 weeks gestation complains of significant bright red vaginal bleeding.
She denies uterine contractions, leakage of fluid or trauma. The patient states that 4 weeks previously,
after she had engaged in sexual intercourse, she experienced some vaginal spotting. On examination,
her blood pressure is 110/60mmHG, Heart rate is 80 beats per minutes and temperature is 37.2C. The
heart and lung examinations are normal. The abdomen is soft and uterus nontender. Fetal heart tones
are in the range of 140-150bpm.