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Ruptured ectopic pregnancy — RCPSC EM MCQ

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HardOB/GYN emergenciesRuptured ectopic pregnancyRCPSC EM

A 29-year-old woman presents CTAS 2 with lower abdominal pain and light vaginal bleeding. She is 7 weeks by dates, BP is 86/52, HR 132, and she has shoulder-tip pain with guarding. Bedside transabdominal ultrasound shows free fluid in the pelvis and no intrauterine pregnancy. What is the most appropriate next step?

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

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Correct answer: C — Activate emergency gynaecology surgery while resuscitating with blood products

This is haemodynamically unstable pregnancy of unknown location with free fluid, highly concerning for ruptured ectopic pregnancy. Resuscitation and urgent operative management are required.

Reference: SOGC Guideline No. 414 pregnancy of unknown location and ectopic pregnancy