Goals and Objectives

  • Resident will be comfortable with initial evaluation and basic management of patients with abdominal pain and/or vaginal bleeding in early pregnancy

Learning Objectives
  • For patients presenting with abdominal pain and/or vaginal bleeding in early pregnancy, resident will be able to:
    • List and define differential diagnoses, including:
      • Ectopic Pregnancy
      • Abortion / Miscarriage
        • Threatened
        • Inevitable
        • Complete
        • Incomplete
        • Missed
        • Septic
    • List early interventions and their indications, including
      • Large-bore IV access
      • Blood transfusion
      • OB-GYN consultation (stat)
      • Vaginal packing
    • List common laboratory tests and their indications, including:
      • CBC
      • Type and screen
      • Quantitative B-hCG
      • Coagulation studies
    • Recite B-hCG "discriminatory zones" for transabdominal and transvaginal ultrasound
    • Describe the technique and indications for transvaginal and transabdominal ultrasound 
      • List the ultrasound findings required to confirm an intrauterine pregnancy
    • Define and discuss the incidence of heterotopic pregnancy in both assisted and unassisted methods of conception
    • Describe the role of methotrexate in ectopic pregnancy
    • Describe the role of RhoGAM in first trimester bleeding and discuss the ACEP and ACOG consensus statements on this topic
Recommended Resources

Prior to Conference

Additional Resources


Consensus Statements

Transvaginal Ultrasound

Original Post by Eric Shappell on 12/04/2014
Reviewed by James Ahn on 01/06/2015
Last Updated by Eric Shappell on 06/12/2015 Contact / Feedback