Question

A 34-year-old woman presents at 10 weeks' gestation with vaginal bleeding and lower abdominal pain. β-hCG is 2,500 IU/L and transvaginal ultrasound does not show an intrauterine pregnancy. She is haemodynamically stable. What is the most appropriate next step?

Accepted Answer

Repeat quantitative β-hCG and transvaginal ultrasound in 48 hours to evaluate for ectopic pregnancy

Answer

Reassure her and discharge without follow-up

Answer

Administer methotrexate immediately without further testing

Answer

Perform dilation and curettage immediately

Answer

Ignore the findings because early pregnancy is always equivocal

Practice question

A 34-year-old woman presents at 10 weeks' gestation with vaginal bleeding and lower abdominal pain. β-hCG is 2,500 IU/L and transvaginal ultrasound does not show an intrauterine pregnancy. She is haemodynamically stable. What is the most appropriate next step?