<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 36-year-old G4P1021 woman comes to the emergency room complaining of intense abdominal pain and vaginal bleeding. She is 9 weeks into her pregnancy and is very concerned as she experienced similar symptoms during her past pregnancy losses. Her pain is described as stabbing, 1010 pain that comes and goes. When asked about her vaginal bleeding, she reports that there were some clots initially, similar to my second day of menstruation. She endorses joint pains that is worse in the morning, allergic rashes at her arms, and fatigue. She denies weight loss, chills, fever, nauseavomiting, diarrhea, or constipation. Physical examination reveals an enlarged and irregularly shaped uterus with a partially open external os and a flesh-colored bulge. Her laboratory findings are shown below:Serum:Hemoglobin: 11.8 gdLHematocrit: 35Leukocyte count:7,600 mm3 with normal differentialPlatelet count: 200,000mm3Bleeding time: 4 minutes Normal: 2-7 minutesProthrombin time: 13 seconds Normal: 11-15 secondsPartial thromboplastin time activated: 30 seconds Normal: 25-40 secondsWhat is the most likely cause of this patients symptoms?? A: Adenomyosis, B: Anti-phospholipid syndrome, C: Chromosomal abnormality, D: Leiomyomata uteri, E: Polycystic ovarian syndrome,  <response>: This is a question about determining the most likely cause of a pregnant womans symptoms of abdominal pain, vaginal bleeding, joint pains, rashes, and fatigue at 9 weeks gestation. The key details in the stem are the pregnancy, prior pregnancy losses, enlarged and irregularly shaped uterus, partially open cervix, normal blood counts except low platelets, and normal coagulation studies. The choices include adenomyosis benign smooth muscle tumors in the uterus, anti-phospholipid syndrome autoimmune disorder causing increased clotting, chromosomal abnormality, uterine fibroids benign tumors, and polycystic ovarian syndrome. Based on the pregnancy, prior losses, uterine enlargement and irregularity, and low platelets, the most likely diagnosis is uterine fibroids or leiomyomata uteri. Fibroids can enlarge and distort the uterine cavity during pregnancy, cause pain and bleeding, and are associated with pregnancy loss. The other choices are less consistent with the clinical presentation.D: Leiomyomata uteri 