O&G: Ruptured ectopic pregnancy with u/l heterotrophic pregnancy
My first case here would be a ruptured ectopic pregnancy with underlying heterotrophic pregnancy. I was called to OT yesterday as I was the EMOT Houseman of the day. I was quite unhappy when I was informed about the case because nobody from antenatal or gynae ward informed me to get ready beforehand. When I reached the OT, only I knew that the case wasn't from the ward but from the emergency department, it was a case of ruptured ectopic pregnancy. Patient is a middle age lady, with history of complete miscarriage about 3 weeks ago, presented to ETD with lower abdominal pain and anaemic symptoms complicated with shock. The BP was low and requiring inotropic support. Initially case referred to surgical team to rule out acute abdomen, CXR no air under diaphragm, AXR no dilated bowels, bedside scan noted some free fluid at Morrison pouch. They also ordered for amylase to rule out pancreatitis. The initial walking diagnosis was septic shock secondary to intraabdominal sepsis. Case then