Question

A 29-year-old woman presents with lower abdominal pain and light vaginal bleeding. She is 7 weeks from her last menstrual period. A urine pregnancy test is positive. She is haemodynamically stable. Transvaginal ultrasound is inconclusive, showing no intrauterine gestational sac. What is the most appropriate next step?

Accepted Answer

Repeat serum hCG in 48 hours and repeat ultrasound when appropriate

Answer

Discharge without follow-up as this is likely a miscarriage

Answer

Immediate laparotomy

Answer

Start methotrexate without further investigation

Answer

Insert intrauterine contraceptive device

Practice question