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Counsel of perfection: Ectopic until proven otherwise. This is not a perfect world. No mention of examination in your case. Was she examined? Would it make any difference if there was no guarding / lateralizing signs / tachycardia? If I couldn't persuade anyone to scan this woman before she left, I would not sleep easy until she returned for an early (24hours?) outpatient scan. Russian roulette springs to mind, but I suspect the odds of an ectopic are a lot, LOT rarer than 1 in 6 in this case. What is an "acceptable" risk to take with this woman's life and fallopian tubes? Does it depend on who you ask? Is there a place for serum beta-hCG +/- progesterone to risk-stratify? Were they done? ?SAH can be an equally problematic differential, with lots of more common non-sinister alternatives, and equally devastating results if sent home. A consultant neurosurgeon I know says if ANY suspicion of SAH, scan (CT/LP). A consultant O&G I know, says a similar thing regarding ectopics and USS. Perhaps my approach is coloured by the fact that both myself and a Consultant I have worked for have had near misses with ??ectopics, and a nursing colleague once spent a few months on ITU after a late-diagnosed ectopic. Are these bad reasons to be cautious? Goat In message <[log in to unmask]>, Craig Ellis <[log in to unmask]> writes >Young woman, 6-7 weeks pregnant, no scan. presents with crampy lower abdo >pain and frequency. no dysuria, no bleeding. no fever. Urine +ve for >protein, blood, leuks and nitrates. > >Would anyone scan her to confirm an IUP or would you be happy to treat the >UTI and send her home to follow-up with GP > >Im reviewing a case - you can guess what happened. > >From the info I have I wouldnt have. Would any of you? > >Craig > >_________________________________________________________________ >Surf the net and talk on the phone with Xtra JetStream @ >http://xtra.co.nz/jetstream -- Goat