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Acute abdominal pain in pregnancy

Case presentation: A 17-year-old female presents to the emergency department with pelvic cramping and vaginal spotting for the past 15 hours. Vital signs are stable. On abdominal exam she has mild lower abdominal tenderness without peritoneal signs. Pelvic exam reveals a closed os and mild bilateral adnexal tenderness. A urine pregnancy test is positive. Blood is obtained for type and screen, and sent for quantitative beta human choriogonadotropin (beta-HCG). A pelvic ultrasound picture is noted below.

Question: Which of the following is true regarding this midline sagittal transabdominal pelvic sonogram?


A With a quantitative beta-HCG of 452 mIU/mL, the findings of the ultrasound are uninterpretable, since this is below the discriminatory zone.
B This image shows an early gestational sac consistent with a quantitative beta-HCG of 600 mIU/mL. The patient should be told she has an intrauterine pregnancy and should follow-up with her obstetrician for routine prenatal care.
C This image shows an early gestational sac consistent with a quantitative beta-HCG of 321 mIU/mL. The patient should be told she probably has an intrauterine pregnancy. Since this is not definite, it is essential that she follow-up with her obstetrician for a repeat evaluation and quantitative beta-HCG in 2–3 days.
D With a quantitative beta-HCG of 250 mIU/mL, the image shows a probable ectopic pregnancy and the obstetrician should be called for an immediate evaluation in the emergency department.
E With a quantitative beta-HCG of 7430 mIU/mL, this image shows an abnormal intrauterine pregnancy and the patient needs to be referred to obstetrician for evaluation of incomplete abortion.


[Image: eme-24.jpg]

Members may check the correct answer file posted below Arrow d (2)
I think the answer is e/
∑잠실오피≪Opyo01.CoM≫ 【오피요】 い행신오피☜홍대오피《분당건마
∑잠실오피≪Opyo01.CoM≫ 【오피요】 い행신오피☜홍대오피《분당건마
∑잠실오피≪Opyo01.CoM≫ 【오피요】 い행신오피☜홍대오피《분당건마
∑잠실오피≪Opyo01.CoM≫ 【오피요】 い행신오피☜홍대오피《분당건마
∑잠실오피≪Opyo01.CoM≫ 【오피요】 い행신오피☜홍대오피《분당건마!ENDVALUE!
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