3-hour Severe Lower Abdominal in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#17419

SMLE Question #17419

Obstetrics & Gynecology General Gynecology

Objective: OBJ-ETH-STERIL

Last updated: February 2026
A 31-year-old G2P1 presents to the emergency department with 3-hour severe lower abdominal pain, dizziness, and mild vaginal bleeding. Her last menstrual period was 7 weeks ago and a home pregnancy test was positive. She is pale and diaphoretic with a distended abdomen and diffuse tenderness with guarding. Transvaginal ultrasound shows no intrauterine gestational sac and free pelvic fluid. What is the most likely diagnosis?

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