Problem 7 A young woman with abnormal vaginal bleeding
A 32-year-old woman attends a general practice because she has had some irregular vaginal bleeding for the last 8 days. Her last normal menstrual period occurred 6 weeks ago. Her usual cycle length is between 4 and 6 weeks. She has been trying to conceive for the last 3 years, but has not managed to do so.
The results of the tests you arranged were as follows:
Investigation 7.1 Summary of results
| Haemoglobin | 42 g/L |
| White cell count | 8.5 × 109/L |
| Platelets | 160 × 109/L |
| Urinary pregnancy test | positive |
| Serum beta hCG | 1200 U/L |
| Cervical PAP smear | no abnormal cells detected; endocervical cells identified |
| Cervical swab | no evidence of chlamydial infection |
On the basis of the positive pregnancy test a pelvic ultrasound examination is arranged (Figure 7.1).
