Which pregnant woman should restrict her weight gain during pregnancy?

Choice A reason: Amniocentesis for fetal lung maturity is not an expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding. It is a procedure that involves inserting a needle into the amniotic sac to obtain a sample of amniotic fluid, which can be used to assess the fetal lung development. It is usually done in late pregnancy or preterm labor, not in the second trimester.

Choice B reason: Contraction stress test (CST) is not an expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding. It is a test that involves stimulating uterine contractions, either by nipple stimulation or oxytocin infusion, to evaluate the fetal heart rate response. It is used to assess fetal well-being and placental function, not to diagnose the cause of bleeding.

Choice C reason: Internal fetal monitoring is not an expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding. It is a method of measuring the fetal heart rate and uterine contractions using electrodes or catheters that are inserted through the cervix and attached to the fetal scalp or the amniotic sac. It is usually done during labor, not in the second trimester.

Choice D reason: Ultrasound for placental location is an expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding. It is a test that uses sound waves to create an image of the uterus, the placenta, and the fetus. It can help to determine the position and attachment of the placenta, which can be the cause of bleeding if it is low-lying or covering the cervix (placenta previa).

Choice E reason: None of the above is not a correct answer. There is one expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding, which is ultrasound for placental location.

Choice A reason: She will not be unable to conceive in the future, as ectopic pregnancy does not necessarily affect her fertility. However, she may have a higher risk of having another ectopic pregnancy or infertility if the fallopian tube is damaged or removed.

Choice B reason: A D&C (dilation and curettage) will not be performed to remove the products of conception, as this procedure is used to empty the uterus, not the fallopian tube. The treatment for ectopic pregnancy may include medication, surgery, or expectant management, depending on the location, size, and viability of the pregnancy.

Choice C reason: Bed rest and analgesics are not the recommended treatment for ectopic pregnancy, as they do not address the underlying cause or prevent complications. Ectopic pregnancy is a medical emergency that requires prompt intervention to prevent rupture, bleeding, and shock.

Choice D reason: Hemorrhage is the major concern for ectopic pregnancy, as the pregnancy can rupture the fallopian tube and cause severe bleeding into the abdominal cavity. This can lead to hypovolemic shock, which is a life-threatening condition.