Last menstrual period

It's been drummed into us during our clinical rotations of general surgery that "every female who's of the age of menarche is pregnant until proven otherwise". To ask them about their last menstrual period (LMP). But this concept clearly escapes doctors a lot and mistakes are being made everyday which can affect the outcome of pregnancies.I remember this particular incident which happened during my CAT days in IGMH. I was assisting an Indian doctor that day and so there came Mrs.X with her husband to us about a vague abdominal pain she was having since one week. She looked generally well and she doesnt seem to be in severe pain and she described it to be vague and occasional.The doctor asked a few questions,and asked me to give the patient a request form for an abdominal x-ray.After a few mins,Mr & Mrs.X came back with the x-ray and lo & behold what a sight greeted us!!
Through the x-ray staring at us ( more like screaming at us) was a single fetus of approximately of 18 weeks old with it's cute umbilical cord,eyes and fingers nearly visible. I was horrified. I doctor's face went blank. She made some stuttering apologies and blamed the patient for not telling her that she was pregnant. Mrs.X said that she had no idea that she could be pregnant. The doctor cunningly kept the x-ray with her and sent off the patient telling her that she has to follow up with an obstetrician. Since that day, this particular incident has occupied my thoughts during odd times. What was this doctor thinking? What was her preliminary diagnosis? Intestinal obstruction? Anyone who deserves to be called a doctor should know the signs and symptoms of intestinal obstruction and as i remember well,the patient was not presenting with any of it. She didn't even ask for the correct view of abdominal x-ray needed for such a case.

Meticulous history taking and a simple lab test will rule out any doubts of a pregnancy and will save doctors facing situations like this. This is the way we are taught in medical school and some how, most of us forget what's important during the course of time. I just wanted to share this with everyone who is in a medical school or is a doctor so that this experience will stay with them everyday as it does with me.