A 37-year-old rural female patient developed pain in the lower abdomen and pelvic regions. Her physician suspects a ruptured ectopic pregnancy. However, because of the isolation of the rural community, no medical imaging or laboratory procedure is available and the physician decides to perform a culdocentesis. In the latter procedure, the needle will aspirate from which of the following spaces?
- ovarian fossa
- rectouterine pouch
- uterine body
- uterine cervix
- vesicouterine pouchAnswer:
Answer(s): B
Explanation:
In culdocentesis, the needle is inserted through the posterior fornix of the vagina and fluid is aspirated from the rectouterine pouch. If nonclotting blood is collected then the likelihood of a ruptured ectopic pregnancy is high. This procedure is rapid and inexpensive, however, serum progesterone level assay or ultrasonography are preferred methods. The ovarian fossa (choice A) or vesicouterine pouch (choice E) are not used in culdocentesis. The uterine body (choice C) and cervix (choice D) would not reveal blood from a ruptured ectopic pregnancy and thus are also not used in culdocentesis.
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