A 36-year-old clerk in her second pregnancy at 8 weeks of gestation presented with bleeding and passing out vesicles per vagina, associated with severe right sided abdominal pain. She was not febrile or pale; her BP was 160/100 mmHg with pulse of 90 bpm.

There was generalised tenderness of the abdomen especially at the right iliac fossa. Uterus was not palpable and there was no tenderness on cervical excitation. There was an adnexal mass which was tender on palpation. Both full blood count (FBC) and urine analysis (UFEME) were within normal range.

What is the the most likely cause of the abdominal pain?

A 45-year-old para 8 lady presented with painless per vaginal bleeding and severe nausea and vomiting for the past three weeks. She had been amenorrhoeic for the past ten weeks. Clinically she was not pale, with blood pressure of 120/80 mmHg, pulse rate of 88 beats per minute and temperature of 37^oC. Abdomen was soft but tender suprapubically with uterus size of 16 weeks. Per speculum and vagina examination revealed minimal bleeding from the cervical os, the os admits one finger. The adnexae and pouch of douglas were normal.

The MOST likely diagnosis is:

A 25-year-old Para 0 was diagnosed as having molar pregnancy. Suction curettage was performed. She defaulted follow-up. Eight weeks post evacuation, she presented again with persistent vaginal bleeding.

Which of the following action would you consider first?

A 25-year-old woman presents to the A + E department with abdominal pain and a positive pregnancy test (8/40). USS is performed to rule out a miscarriage. USS shows an intrauterine gestational sac with the ratio of transverse to anteroposterior dimension, greater than 1.5 with cystic spaces in the placenta. What is the likely ultrasonographic diagnosis?

A 30-year-old housewife para 0 complains of bleeding pervaginum after 3 months amenorrhea. Her vital signs are stable with clinical haemoglobin level of 10 g/dl and upon palpation of the abdomen, the uterus is enlarged to 16 weeks size gravid uterus. Speculum and vaginal examination reveals presence of vesicles with active bleeding.

The most appropriate management for this patient is: