Question

You have a patient that presents with sxs of a similar to an pregnancy, but then with review of serum hormones this supports an *abnormal pregnancy* (first b-hCG 750 mIU/mL and in next 48 hrs 760 mIU/mL; then progesterone 3.2 ng/dL). On U/S you observe a *yolk sac* in the uterus, NO fetal pole and a cyst on the ovary. What should you do now?

Answer 1

Based on the symptoms and test results, further evaluation and management should be undertaken for the patient presenting with symptoms suggestive of an abnormal pregnancy. The presence of an ovarian cyst and abnormal hormone levels can be consistent with an ectopic pregnancy, which may require additional diagnostic tests and prompt treatment.

Step-by-step explanation:

Based on the symptoms and test results, the patient's condition is suggestive of an abnormal pregnancy. The serum hormone levels of b-hCG and progesterone are not consistent with a normal pregnancy. Additionally, the ultrasound findings of a yolk sac, no fetal pole, and an ovarian cyst further indicate an abnormal pregnancy.

In this case, further evaluation and management should be undertaken. The patient should be counseled about the possibility of an ectopic pregnancy, as the presence of an ovarian cyst and the abnormal hormone levels can be consistent with this condition. Additional diagnostic tests such as serial b-hCG measurements, repeat ultrasounds, and possibly exploratory laparoscopy may be required to confirm the diagnosis and determine the appropriate management approach.

It is important for the patient to be closely monitored and promptly treated as ectopic pregnancies can be life-threatening.