Question

A hemodynamically stable 29-year-old with a 6-week pregnancy has rising β‑hCG 3,500 mIU/mL, no intrauterine gestation on high-quality transvaginal ultrasound, and no fetal cardiac activity; she is reliable for follow-up. Best management?

Accepted Answer

Methotrexate therapy

Answer

Immediate laparotomy

Answer

Expectant outpatient management without follow-up

Answer

D&C as first-line

Answer

Discharge with return only if pain worsens

Practice question

A hemodynamically stable 29-year-old with a 6-week pregnancy has rising β‑hCG 3,500 mIU/mL, no intrauterine gestation on high-quality transvaginal ultrasound, and no fetal cardiac activity; she is reliable for follow-up. Best management?