Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of severe, sharp, unilateral lower abdominal pain, associated with vaginal spotting and syncope. History significant for missed LMP, positive home pregnancy test, and absence of prior ultrasound confirmation of intrauterine pregnancy. Denies fever or chills. Reports dizziness and lightheadedness consistent with hemodynamic instability.
Clinical Examination Findings
Patient is pale, diaphoretic, and tachycardic. Abdominal exam reveals significant tenderness, guarding, and rebound tenderness, most pronounced in the [Right/Left] lower quadrant. Pelvic exam demonstrates cervical motion tenderness (CMT) and fullness in the adnexa. Hemodynamic status: BP [XX/XX], HR [XXX], O2 sat [XX%].
Treatment Protocol
Immediate resuscitation initiated with large-bore IV access and fluid bolus. Type and cross-match for emergency blood transfusion. Emergent surgical consultation for laparoscopic or open salpingectomy/salpingostomy. Monitoring of serial HCG levels and hemodynamic stability. Prophylactic antibiotics and Rh immunoglobulin administration if indicated.