Ectopic Pregnancy, Ruptured Haemorrhagic Shock, and Early Pregnancy Emergencies — WACS Viva & Clinical Scenarios (Gynaecology)

Exam-style ectopic pregnancy, ruptured haemorrhagic shock, and early pregnancy emergencies viva scenarios with examiner probes and model answers for…

Scenarios covered

• SCENARIO 1: A 24-year-old G2P1 woman presents to the emergency room with sudden severe lower abdominal pain, syncopal attacks, and shoulder tip pain. Blood pressure is 70/40 mmHg, heart rate is 142 bpm (thready), SpO2 is 94% on room air, and point-of-care ultrasound reveals massive haemoperitoneum. Gynaecology decides on an immediate exploratory laparotomy. Describe your immediate resuscitation and anaesthetic management.
• SCENARIO 2: A 32-year-old primigravida at 8 weeks of gestation following in vitro fertilisation presents with a ruptured cornual ectopic pregnancy. She has lost an estimated 2 litres of blood. You have only 2 units of uncrossmatched whole blood immediately available in your facility. Detail your induction strategy, intraoperative fluid/blood management, and invasive monitoring choices.
• SCENARIO 3: A 28-year-old woman is rushed to theatre following an uncomplicated dilatation and curettage at a peripheral clinic that was complicated by acute uterine perforation and bowel injury, now presenting 18 hours later with septic shock, peritonitis, BP 80/50 mmHg, HR 135 bpm, and temperature 39.2°C. Formulate your perioperative anaesthetic plan.
• SCENARIO 4: A 20-year-old nullipara presents at 14 weeks uterine size with vaginal bleeding, hyperemesis, resting tachycardia (HR 130 bpm), and a snowstorm appearance on ultrasound diagnostic of a hydatidiform mole. Detail your preoperative risk stratification, anaesthetic technique, and preparedness for intraoperative pulmonary and endocrine complications.