Approach to first trimester bleeding Quiz: Ace Your Exams
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A 24-year-old woman, G1P0, at 8 weeks gestation presents to the clinic with intermittent, light vaginal bleeding for the past two days. She has had an increase in vaginal discharge and occasional mild dysuria for the past week. She does not have fever, chills, abdominal pain, or dyspareunia. Medical and surgical histories are unremarkable. The last PAP smear done eight months ago was normal. The patient lives apart from the biological father. Vital signs are within normal limits. Abdominal examination is unremarkable. Pelvic examination reveals an erythematous cervix with a closed os, the presence of mucopurulent discharge, and mild cervical bleeding when it is touched with a swab. Transvaginal ultrasound reveals an 8-week intrauterine embryo with a heartbeat. Which of the following historical elements, if present, would be most consistent with the likely underlying diagnosis?
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