Lower Abdominal Pain in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#1543
SMLE Question #1543
Obstetrics & Gynecology
General Gynecology
Objective: OBJ-ETH-STERIL
Last updated: February 2026
A 29-year-old G2P1 woman at 8 weeks’ gestation presents to the emergency department with lower abdominal pain and vaginal spotting. Transvaginal ultrasound suggests a right tubal ectopic pregnancy; no fetal cardiac activity is detected, and the adnexal mass measures about 4 cm. The team is considering methotrexate therapy. Which of the following is an absolute contraindication to methotrexate management?
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