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Ruptured ectopic pregnancy — ABEM Board MCQ

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EasyOB/GYN emergenciesRuptured ectopic pregnancyABEM Board

A 26-year-old woman arrives with syncope and lower abdominal pain. Triage acuity is ESI 1; BP 76/42 mm Hg, HR 138/min. Pregnancy test is positive. Bedside ultrasound shows no intrauterine pregnancy and free intraperitoneal fluid. She is pale and diaphoretic. Which of the following is the most appropriate initial action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Begin resuscitation and call obstetrics for emergent operative management

Unstable suspected ruptured ectopic pregnancy requires immediate resuscitation and surgical management.

Reference: ACEP Early Pregnancy clinical policy; ACOG ectopic pregnancy guidance