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Pregnancy of unknown location — MCCQE Part 1 MCQ

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ModeratePelvic PainPregnancy of unknown locationMCCQE Part 1

A 20-year-old woman has amenorrhoea x 7 weeks, lower abdominal pain, and light vaginal bleeding. Beta-hCG 1500 IU/L. TVU: empty uterus, no adnexal mass. Most appropriate next step?

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Correct answer: E — Repeat beta-hCG in 48 hours

Beta-hCG below discriminatory zone: cannot determine pregnancy location. Serial hCG q48h: normal rise suggests viable IUP, plateau/slow rise suggests ectopic, decline suggests non-viable. Premature methotrexate risks viable IUP.

Reference: SOGC Ectopic Pregnancy No. 414