Question

A 26-year-old woman presents with lower abdominal pain and vaginal spotting at 7 weeks' gestation by last menstrual period. Her beta-hCG is 1500 IU/L and transvaginal ultrasound shows no intrauterine pregnancy. She is haemodynamically stable. What is the most appropriate next step?

Accepted Answer

Repeat beta-hCG in 48 hours and repeat ultrasound to assess for evolving ectopic or early intrauterine pregnancy

Answer

Reassure and discharge without follow-up

Answer

Diagnose complete miscarriage and provide routine follow-up

Answer

Treat as ectopic pregnancy with methotrexate immediately without further testing

Answer

Schedule elective curettage tomorrow without further assessment

Practice question

A 26-year-old woman presents with lower abdominal pain and vaginal spotting at 7 weeks' gestation by last menstrual period. Her beta-hCG is 1500 IU/L and transvaginal ultrasound shows no intrauterine pregnancy. She is haemodynamically stable. What is the most appropriate next step?