Station 7- Ruptured ectopic pregnancy and breaking bad news Patient Scenario You are Mrs White, a 30 year

old accountant who presents to the AnE complaining of per painless vaginal bleeding. Two day history of per vaginal bleeding that is bright red and lost about 3 teaspoons of blood. You are pregnant and at 28 weeks gestation. There are no urinary or bowel symptoms. You are not pyrexial with no systemic upsets such as night sweats, chills, rigors. Gynaecological history Your periods are regular, 28 day cycle, last for 5 days, no menorrahagia or spotting. Your menarche was 12 years old. You used to take OCP and the copper coil in the past few years but have stopped for one year now. Your last smear was normal, 2 years ago You have no previous sexually transmitted infections Obstetrics history You have been pregnant three times, have 2 children, with 1 termination of pregnancy. Both children are born via vaginal delivery with no complications and weigh a healthy 2.8-3 kg at birth. For intercurrent pregnancies, all scans were normal up to date. No family history of preeclampsia or gestational diabetes. Past medical history include appendicitis as a child, with an appendicectomy performed. You do not smoke and drink occasional alcohol and work as an accountant. BREAKING BAD NEWS You dont understand placenta previa is. You dont understand how this will affect the birth. You want a home birth for this child, as with your other ones and are adamant about this. Be angry.