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OG6.1 | Diagnosis of Pregnancy — SDL Guide (Part 3)

Self-Assessment

The diagnosis of pregnancy integrates clinical examination, biochemical testing, and ultrasonographic assessment into a coherent clinical reasoning process. This module has covered the three-tier classification of clinical signs, the mechanism and interpretation of hCG-based tests, the ultrasonographic milestones of early pregnancy, gestational age calculation, differential diagnosis, and the clinical applications including serial hCG interpretation, the discriminatory zone concept, and medico-legal implications. The following scenarios apply this knowledge to realistic clinical presentations — the same presentations you will encounter as an intern, junior resident, or medical officer, and the same scenarios that appear in written, OSPE, and viva examinations. These cases are not designed to test factual recall alone; they are designed to test whether you can move from a set of findings to a management decision, which is the clinical skill the examination is actually assessing. Reason through each case systematically before checking your answers.

1. A 25-year-old woman presents with 6 weeks of amenorrhoea and mild lower abdominal discomfort. Urine pregnancy test is positive. TVS shows no intrauterine sac. Serum β-hCG is 2,400 mIU/mL. What is the diagnosis, and what is the immediate management?

1. A 28-year-old woman's LMP was 5th August. Her cycles are regular at 28 days. Today is 5th November. What is her current gestational age in weeks, and what is her EDD?

1. A 32-year-old woman with confirmed intrauterine pregnancy at 6 weeks has serum β-hCG of 8,000 mIU/mL on Day 1 and 8,200 mIU/mL on Day 3 (48 hours later). How do you interpret this, and what should be done next?