A 23-year-old woman presents to the GP with left iliac fossa pain. A pregnancy test is positive. Transvaginal ultrasound shows an empty uterus and a 2...

Question

A 23-year-old woman presents to the GP with left iliac fossa pain. A pregnancy test is positive. Transvaginal ultrasound shows an empty uterus and a 2 cm left adnexal mass consistent with an unruptured ectopic pregnancy. There is no fetal heartbeat. Her serum beta-hCG is 2,800 IU/L. She is clinically stable, her renal and liver function are normal, and her platelet count is 210 × 10⁹/L. She does not wish to have surgery. Which is the single most appropriate management?

Accepted Answer

Intramuscular methotrexate 50 mg/m²

Answer

Expectant management with serial beta-hCG monitoring

Answer

Oral mifepristone 200 mg

Answer

Surgical management - laparoscopic salpingectomy

Answer

Intramuscular methotrexate is only suitable if beta-hCG is

uk-drcog MCQ (SBA): Medical Management of Ectopic Pregnancy