9505020091087

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Presence of unilateral (one sided) abdominal or lower pelvic pain?

Vaginal bleeding or spotting in the last 1 or 2 weeks?

Has the period of amenorrhoea been MORE than 9 weeks?

Does she have a history of ectopic pregnancy?

Does she have a history of tubal damage or surgical sterilization?

Does she have an IUD or Mirena or any other intra-uterine device in situ?

Does she suffer from or take medication for cardiovascular disease or hypertension?

Does she have Porphyria?

Does she have Asthma? If yes, is it uncontrolled?

Does she have any adrenal gland dysfunction?

Does she have any other illness or diseases?

Does she use steroids long term?

Does she use blood thinners (anticoagulants)

Does she have allergies to any of the medication in the pack?

Does she NOT have access to emergency care? (Hospital or Clinic)

Only fill in if you are not human

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