Obstetrics and Gynecology: Differential Diagnosis and Investigations Quiz

Pregnancy Complications

• The most likely differential diagnosis for a pregnant lady with vaginal bleeding and abdominal distension is an ectopic pregnancy.
• Serum β-hCG investigation is used to assess the discriminative zone in early pregnancy.

Expectant Management Approach

• One of the key factors considered for the 'EXPECTANT' management approach is the presence of a viable intrauterine pregnancy.
• Factors considered for initiating 'EXPECTANT' management include the presence of a viable intrauterine pregnancy, low serum β-hCG levels, and minimal symptoms.

Infection Screening

• The primary purpose of conducting an infection screen in this scenario is to identify potential infections that may be contributing to the vaginal bleeding and abdominal distension.
• Chlamydia is typically screened for in a pregnant lady with vaginal bleeding and abdominal distension.
• HIV is not typically screened for in a pregnant lady with vaginal bleeding and abdominal distension.

β-hCG Levels

• The optimal rise of serum β-hCG that should be assessed in early pregnancy is 66% every 48 hours.
• The discriminative zone of serum β-hCG is reached at 1000-1500 IU/L.

Ultrasound Investigation

• A transvaginal ultrasound must identify a fetal heartbeat to confirm a viable intrauterine pregnancy.

Co-Existing Conditions

• A heterotopic pregnancy can co-exist with a viable intrauterine pregnancy as a result of IVF treatment.

Blood Investigations

• Serum β-hCG levels and full blood count should be assessed in the bloods investigation for a pregnant lady presenting with vaginal bleeding and abdominal distension.