Test and teach Number 69 Part 1

A 26 yr old gravida 3 para 3 married woman presented with a 6 mth history of heavy menstrual periods. Two wks prior to presentation she developed Severe sharp left lower abdominal pain which began 3 days into a period. The pain moderated but persisted as a dull ache with occasional exacerbations. The pain was associated with continued vaginal bleeding.