A woman complains of right-sided lower abdominal pain and mild bleeding per vagina for one day after a period of amenorrhoea of 6 weeks. Her general condition is satisfactory. There is tenderness in the right iliac fossa. The urine hCG test is positive. Transvaginal ultrasound scan does not reveal an adnexal mass or an intrauterine pregnancy.What is the next step in the management?
Ans. is c, i.e. Perform two serum bhCG tests 48 hours apartNow in this question:Patient has Rt sided abdominal pain + tenderness + Amenorrhea of 6 weeks + Bleeding + UPT is positive + TVS is unconfirmatorySo most probably diagnosis is ectopic but D/D can be:(i) Abortion(ii) Early intrauterine pregnancy.
Commence treatment with methotrexate
Perform a laparoscopic examination
Perform two serum beta hCG tests 48 hours apart
Repeat the ultrasound scan after 7 days
Ecotopic Pregnancy