Question 39 · LEK · Ectopic pregnancy
If hypogastric pain appears approx. 2-3 days after the administration of methotrexate in a patient treated for ectopic pregnancy, you should:
- A. perform urgent laparotomy with the longitudinal incision - this symptom means that there is haemorrhage because of ectopic pregnancy rupture.
- B. perform urgent laparoscopy - this symptom means that there is haemorrhage because of ectopic pregnancy rupture.
- C. perform urgent laparotomy with the transverse incision - this symptom means that there is haemorrhage because of ectopic pregnancy rupture.
- D. observe the patient and monitor decrease in the hCG level - this is a typical pain after the treatment with methotrexate.
- E. discharge the patient and inform her that the pain is most probably caused by ovulation.
Hint
Recall the common, usually self-limiting side effect seen a few days after methotrexate in a hemodynamically stable patient.
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