Question

A 30-year-old woman at 7 weeks gestation presents with vaginal spotting and right iliac fossa pain. Her beta-hCG is 1800 IU per litre. She is haemodynamically stable. Transabdominal ultrasound shows no intrauterine pregnancy. What is the most appropriate next step?

Accepted Answer

Urgent transvaginal ultrasound in early pregnancy assessment unit

Answer

Discharge with reassurance and repeat pregnancy test in 4 weeks

Answer

Schedule elective termination of pregnancy

Answer

Start Misoprostol for presumed miscarriage

Answer

Immediate laparotomy for all suspected ectopic pregnancies

Practice question

A 30-year-old woman at 7 weeks gestation presents with vaginal spotting and right iliac fossa pain. Her beta-hCG is 1800 IU per litre. She is haemodynamically stable. Transabdominal ultrasound shows no intrauterine pregnancy. What is the most appropriate next step?