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Pregnancy of unknown location — DRCOG MCQ

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HardEarly PregnancyPregnancy of unknown locationDRCOG

A 35-year-old woman has a positive pregnancy test and mild pelvic discomfort. Transvaginal ultrasound shows no intrauterine or extrauterine pregnancy. Serum hCG is 620 IU/L and she is haemodynamically stable. What is the most appropriate investigation?

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

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Correct answer: B — Repeat serum hCG in 48 hours

This is a pregnancy of unknown location, and serial hCG measurement at 48 hours helps determine likely trajectory and need for further imaging or intervention. Low hCG does not exclude ectopic pregnancy. Methotrexate or laparoscopy requires stronger evidence or clinical deterioration. The pearl is that PUL is a temporary classification, not a final diagnosis.

Reference: NICE NG126