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Early pregnancy pain ectopic risk — DFSRH MCQ

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HardReproductive healthEarly pregnancy pain ectopic riskDFSRH

A 29-year-old with a previous ectopic pregnancy has 6 weeks' amenorrhoea, a positive pregnancy test and left iliac fossa pain. Pulse is 96/min, blood pressure 112/74 mmHg and there is no shoulder-tip pain. What is the most appropriate investigation?

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Correct answer: BUrgent transvaginal ultrasound and quantitative hCG pathway

Previous ectopic pregnancy plus pain in early pregnancy requires urgent ectopic pregnancy assessment with ultrasound and serial hCG as needed. Stable observations do not exclude ectopic pregnancy. Delaying to routine booking could miss a potentially serious diagnosis.

Reference: NICE Ectopic Pregnancy and Miscarriage Guideline