The Gynecology Registrar
Dear Gynecology Registrar
Re: Ms Cathy Jones, aged 25 years
Ms Cathy Jones, aged 25 who requires an immediate referral for severe abdominal pain associated with mild vaginal bleeding at the A and E department.
Ms Jones on 15.02.2013 visited GP with complaints of lower abdominal pain especially at right illiac forsa and an iregular bleeding. Using POP from last two months and no other specific symptoms noted with bowel and bladder. On examination, the vitals are stable with mild tenderness in illiac forsa and no mass was evident but non-specific abdominal pain was present. Therefore, the GP advised for few blood tests for reassessment the next day.
Today, the patient presented with worsened abdominal pain and mild vaginal bleeding. On interrogation the patient also complained of pain in the left shoulder. On assessment, tenderness of right iliac forsa. The vitals are within normal limits and the per-vaginal examination showed cervical excitation. However, the pregnancy test revealed positive and the urine test is clear as shown in dipstick.
Therefore, it may be an ectopic pregnancy which can br confirmed by further assessment.
Should you need any further assistance please, do not hesitate to call me.