No Peritoneal Signs in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#1575
SMLE Question #1575
Obstetrics & Gynecology
General Gynecology
Objective: OBJ-ETH-STERIL
Last updated: February 2026
A 27-year-old G2P0 woman has 6 weeks of amenorrhea, mild lower abdominal pain, and scant vaginal spotting. Transvaginal ultrasound shows no intrauterine gestational sac and a 2.5-cm right adnexal mass without free fluid. She received single-dose intramuscular methotrexate 5 days ago. Serial serum β-hCG rises on day 4 and again on day 7 after treatment. She remains haemodynamically stable with no peritoneal signs. What is the most appropriate next step in management?
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