Dr Sarah Hindley

Freshfields Surgery
66 Honeybourne Lane
Oldtown

21.06.2019

Dear Dr Sarah Hindley,

Re: Marilyn Johnson DOB: 04.01.2002

I am writing to update you on the progress of your patient, Mrs Marilyn Hindley, a 27-year-
old married woman who was admitted to Oldtown Hospital on 21.06.2019 with a diagnosis
of a ruptured tubal ectopic pregnancy. She is being discharged but require ongoing
monitoring and management.

During hospitalization, Mrs Johnson has made steady progress, and her vital signs are within
normal limits. Post-operative pain has been managed with Diclofenac. Upon examination,
TV ultrasound revealed an empty uterine cavity and the presence of free fluid in the Douglas
pouch. In addition, laparoscopy confirmed the presence of hemoperitoneum ana a leaking
left tubal pregnancy in the ampullary region, which necessitated a left salpingectomy.
However her contralateral tube id healthy. She has been educated avoiding sexual
intercourse for two months, using carrier contraception if takes place.

Mrs John is anxious about starting a new pregnancy. It would be appreciated if you could
arrange counselling for her. She would benefit from an hCG test before attempting
pregnancy and continuing this testing for two menstrual cycles for 3 months. I would be
grateful if you could provide an early ultrasound scan to verify the location of embryo as
well as monitoring hCG levels for future pregnancy. Additionally, folic acid supplements
should be applied.

Please do not hesitate to contact me if you any questions.

Yours sincerely,
Ward Nurse