23rd December 2021

A 30-year-old woman is brought into A+E via ambulance. Her partner woke up to see a lot of blood in the bed, and that the patient was clutching her abdomen in pain

A 30-year-old woman is brought into A+E via ambulance. Her partner woke up to see a lot of blood in the bed, and that the patient was clutching her abdomen in pain. The patient is 20 weeks pregnant, with no previous children, and no further medical history of note.

The patient is conscious and responds to voice. She appears to be in a lot of pain and is guarding her lower abdomen. You can see that her pyjamas bottoms have been soaked in blood.

On examination:

• Airways clear
• RR 30, O2 sats 95% on air, chest clear
• HR 130, BP 90/60, heart sounds present (S1, S2, 0), central capillary refill 3 seconds.
• She is responsive to voice, with pupils equal and reactive to light
• She appears to be in pain with guarding of the lower abdomen, and her pyjama bottoms are soaked in blood.

Which blood investigation should be requested immediately?

Select the SINGLE most appropriate option from the list below. Select ONE option only.