Pitfalls

Failure to diagnose pregnancy. Every women of reproductive age with lower abdominal pain or PV bleeding should have a pregnancy test.

Failure to recognise cervical shock.

Failure to diagnose an ectopic pregnancy. Remember:

• Ectopic pregnancies can present with symptoms that mimic gastroenteritis
• Cornual pregnancies rupture at a later gestation
• The possibility of a heterotropic pregnancy
• An ectopic pregnancy with falling βhCG levels may still rupture

Failure to appreciate the extent of haemorrhage and consider concealed haemorrhage.

Failure to prevent isoimmunisation.

Failure to involve experienced specialists early.