A 29-year-old woman, gravida 2 para 2, comes to the emergency department with severe abdominal pain in the left lower quadrant and vaginal bleeding. She is saturating a pad every 3-4 hours. Her last menstrual period was 7 weeks ago. Past surgical history is significant for 2 cesarean deliveries and permanent sterilization via a bilateral tubal ligation. A urine pregnancy test is positive, and an ultrasound shows a 2-cm mass in the left adnexa adjacent to the ovary and a thickened endometrial stripe. If a uterine curettage is performed, which of the following findings would be expected in this patient?

Question

A 29-year-old woman, gravida 2 para 2, comes to the emergency department with severe abdominal pain in the left lower quadrant and vaginal bleeding.  She is saturating a pad every 3-4 hours.  Her last menstrual period was 7 weeks ago.  Past surgical history is significant for 2 cesarean deliveries and permanent sterilization via a bilateral tubal ligation.  A urine pregnancy test is positive, and an ultrasound shows a 2-cm mass in the left adnexa adjacent to the ovary and a thickened endometrial stripe.  If a uterine curettage is performed, which of the following findings would be expected in this patient?

Quizplus · Accepted Answer

Eductional Objective: An ectopic pregnancy is characterized by implantation outside of the uterus.  Uterine curettage would reveal decidual changes in the endometrium due to progesterone secretion but no embryonic or trophoblastic tissue (eg, no villi).

A 29-Year-Old Woman, Gravida 2 Para 2, Comes to the Emergency