Jane Smith is 34 years old and 19 weeks pregnant with her first child. She presented to the emergency department, because over the past 48 hours, she began noticing significant blood in her stools, a symptom she has not previously experienced. She denies vaginal bleeding but describes the rectal blood as “bright red.” Earlier that morning, Jane also experienced rectal bleeding in the absence of a bowel movement and grew increasingly concerned. Jane was diagnosed with irritable bowel syndrome with constipation (IBS-C) several years ago, but she has never been examined more closely by a gastroenterologist to rule out potentially more serious causes of her symptoms. Jane has also expressed several times throughout her pregnancy that she is very excited to “finally be pregnant,” after trying unsuccessfully for 3 years, and that she “would do anything” to keep her baby safe and carry the pregnancy to term. Jane was in...

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