ABSTRACT
All gynaecological emergencies that present with abdominal pain or vaginal bleeding require a thorough history and examination. Be delicate and empathic when taking the history of the presenting complaint and discussing the patient's gynaecological and sexual history. Pelvic inflammatory disease is a notoriously difficult diagnosis to make, being easily missed or conversely diagnosed when not present. Laparoscopy is the gold standard but is reserved for complicated cases and when the diagnosis is unclear. The two most important causes are ectopic pregnancy and spontaneous miscarriage. A patient presenting with a positive pregnancy test, abdominal pain, scanty vaginal bleeding and absence of intrauterine pregnancy on ultrasound scan has an ectopic pregnancy until proven otherwise. Treatment priorities for trauma in a pregnant patient are the same as for the non-pregnant patient. The best treatment for the fetus is to rapidly stabilize the mother.
