Bleeding and pain in early pregnancy: what are the likely problems? George Condous

All women of reproductive age with lower abdominal pain, abnormal vaginal bleeding or even gastrointestinal symptoms who present to general practitioners or emergency departments should have a urinary pregnancy test (positive at serum human chorionic gonadotrophin (hCG) levels ≥25 IU/L). The burden of responsibility rests on the shoulders of clinicians – not considering an ectopic pregnancy was a common theme in the most recent Confidential Enquiries into Maternal Deaths (CEMD) in the United Kingdom (UK). In the CEMD, 11 out of

15 direct deaths in the first trimester were due to ectopic pregnancy.4