Young woman with severe abdominal pain: conclusion

A 17-year-old girl presented to a fire station complaining of severe abdominal pain one afternoon. The patient appeared acutely ill and had an initial blood pressure of 62 mmHg by palpation and a heart rate of 110 beats per minute. A flight crew was summoned to the scene. History obtained only through a Spanish-speaking interpreter revealed the patient to be approximately 6 months pregnant and without any prenatal care. Physical assessment revealed the patient to be alert and oriented but weak, pale, and diaphoretic. The abdomen examination demonstrated diffuse, severe tenderness and guarding to palpation. There was no evidence of vaginal bleeding or signs of imminent delivery. A repeat blood pressure by the flight crew was 82 mmHg by palpation.