A woman with left iliac fossa pain and light vaginal bleeding is haemodynamically stable. Ultrasound shows a 2 cm unruptured tubal ectopic pregnancy without cardiac activity, her hCG is low and she can attend follow-up. What is a reasonable option?
Answer and explanation
Correct answer: B. Methotrexate, with hCG follow-up
- Step 1: Treatment depends on stability, size, hCG and symptoms. Step 2. Stable women with low hCG and no cardiac activity can be treated medically or expectantly, with salpingectomy for others, and follow-up of hCG. Answer: Methotrexate, with hCG follow-up. Why not the others: Hysterectomy is not indicated. Misoprostol alone does not treat an ectopic. Discharge without follow-up risks rupture.
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