skip to main content

Ectopic pregnancy management — USMLE Step 3 MCQ

Instant feedback + full explanation. One question, done properly.

HardOB/GYN (prenatal care, contraception, screening)Ectopic pregnancy managementUSMLE Step 3

After evacuation of a complete molar pregnancy, weekly beta-hCG values plateau over four measurements and then rise. Ultrasound shows an empty uterus and she is stable. What is the best next step?

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

Reveal the answer and explanation

Correct answer: D — Stage gestational trophoblastic neoplasia and begin risk-directed chemotherapy

The best answer is “Stage gestational trophoblastic neoplasia and begin risk-directed chemotherapy”. A plateau or rise in serial hCG after molar evacuation meets criteria for postmolar GTN. Evaluation determines extent and prognostic score, which guides single- versus multiagent chemotherapy. Plateauing or rising hCG after molar evacuation establishes persistent gestational trophoblastic neoplasia requiring staging and treatment.

Reference: NCI: Gestational Trophoblastic Disease Treatment: https://www.cancer.gov/types/gestational-trophoblastic/hp/gtd-treatment-pdq