Question

A 19-year-old G1P0 at 6 weeks by dates presents to the ED complaining of a small amount of vaginal spotting for the past 2 days. Vital signs are within normal limits. Your pelvic exam reveals a closed os and no adnexal tenderness or masses. Laboratory analysis reveals a serum beta hCG of 1830 mIU/ml and type B, Rh-positive blood. A transvaginal ultrasound shows an intrauterine gestational sac without a yolk sac or fetal pole and a right ovarian cyst that measures 2 x 1 cm. Given this information, which of the following is the most likely diagnosis?

a) Blighted ovum
b) Ectopic pregnancy
c) Implantation bleeding
d) Threatened miscarriage

Answer 1

The most likely diagnosis is ectopic pregnancy, as indicated by the patient's symptoms and medical findings.

Step-by-step explanation:

Based on the given information, the most likely diagnosis is b) Ectopic pregnancy. An ectopic pregnancy occurs when a fertilized egg implants outside of the uterus, usually in the fallopian tube. In this case, the patient's closed cervix, presence of an ovarian cyst, and absence of a yolk sac or fetal pole on ultrasound are all consistent with an ectopic pregnancy. It is important for the patient to seek further medical evaluation and management.