11-20-2011, 07:42 PM
#1
A 37-year-old woman, gravida 3, para 2, comes to her physician for follow-
up on her ectopic pregnancy. She was diagnosed with an ectopic pregnancy
7 days ago and given methotrexate. She now presents with abdominal pain
that started this morning. Examination is significant for moderate left lower
quadrant tenderness. Laboratory analysis shows that her beta-hCG value
has doubled over the past week. Transvaginal ultrasound shows that the
ectopic pregnancy is roughly the same size but there is an increased
amount of fluid in the pelvis. Which of the following is the most appropriate
next step in management?
A. Expectant management
B. Repeat methotrexate
C. Laparoscopy
D. Oophorectomy
E. Hysterectomy