QUESTION 10

A 31-year-old primigravida at 7 weeks gestation is brought to the emergency department by her husband due to vaginal bleeding and
lower abdominal pain The bleeding began 4 hours earlier, and the patient has saturated 3 perinea! pads in that time. Her abdominal
cramping has become progressively more severe and unresponsive to acetaminophen. She has no fevers, chills, or abnormal vaginal
discharge The patient was treated at age 18 for Chlamydia trachomatis cervicitis. Her surgical history includes a loop electrode
excision procedure for high-grade cervical intraepithelial neoplasi.a, but she has had normal Pap tests since. The patient takes a
prenatal vitamin daily and does not use tobacco, alcohol, or illicit drugs. Temperature is 37 C (98.7 F), blood pressure is 100/76 mm
Hg, pulse is 112/min, and respirations are 14/min. Pelvic examination reveals blood clots in the vaginal vault and active bleeding from
a dilated cervix. A bimanual examination demonstrates a 6-week-size tender uterus. Ultrasound reveals a gestational sac in the
lower segment of the uterus, a simple cyst in the right ovary, and free fluid in the posterior cul-de-sac. Which of the following is the
most likely diagnosis of this patient?
QA Acute cervicitis
0 B. Cervical insufficiency
0 C. Ectopic pregnancy
0 D. Hydatidiform mole
0 E. Inevitable abortion
0 F Missed abortion
0 G. Threatened abortion