MSFinals-1843

MSFinals-1843

A 25-year-old primigravida patient at 6 weeks gestation presents with suprapubic pain and spotting. She also complains of shoulder-tip pain and nausea. Upon observation, her oxygen saturations are at 98% in room air, blood pressure is at 109/79 mmHg, heart rate is at 107 bpm, and temperature is at 36.9ºC. Further investigations reveal an empty uterine cavity with tubal ring sign on transvaginal ultrasound and evidence of a 41 mm complex adnexal mass. Her Hb levels are at 107 g/L (115 – 160), platelets at 380 * 109/L (150 – 400), WBC at 10.8 * 109/L (4.0 – 11.0), and b-HCG at 1650 IU/L (< 5). What is the most appropriate management plan for this patient?