A 31 year's old women complains of worsening obdominal pain for 4days she is pregnant in her third pregnancy .she has a 10 year's old son by normal vaginal delivery and had a miscarriage 8 year's ago her pregnancy hasbeen an eventual until know with unremarkable first trimester maid of honor garments in royal purple
The pain is in the left lower obdomen and is constant and sharp
She has taken only paracetamo with little effect and she is un able to sleep deu to the pain
She has had no vaginal bleeding and rep ... orts urinary frequency since the beginning of the pregnancy she is mild constipation and has no nausea and vomiting there's no history of trauma she has no felt the babay moving yet
# examination the women is a pyrexial and pulse rate 125/minute with blood pressure 110/65
The uterus is palpable just above the umbilical.
There is significant tenderness of the left utrine funds
The examination shows a normal speculum shows a normal closed cervix no blood the fetal heart is hear with hand held fetal palpitations
What is the effect of this condition ?
What is likely diagnosis and how should it confirmed ?
How would you manage these women ?

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