A 29-year-old woman has severe lower abdominal pain and syncope. Last menstrual period was 7 weeks ago. Blood pressure is 84/50 mm Hg, pregnancy test

Question

A 29-year-old woman has severe lower abdominal pain and syncope. Last menstrual period was 7 weeks ago. Blood pressure is 84/50 mm Hg, pregnancy test is positive, and ultrasound shows free intraperitoneal fluid with no intrauterine pregnancy. Which of the following is the most appropriate next step in management?

Accepted Answer

Immediate surgical management

Answer

Outpatient methotrexate

Answer

Discharge with analgesics

Answer

Repeat beta-hCG in 48 hours

Answer

Start combined oral contraception

Ruptured ectopic pregnancy — USMLE Step 3 MCQ