A 22-year-old female presents with lower abdominal pain and a positive urine pregnancy test. On transvaginal ultrasound, there is an ectopic pregnancy in the right fallopian tube with free fluid in the pelvis. What is the most appropriate initial treatment? A) Intravenous ceftriaxone and doxycycline B) Methotrexate injection C) Laparoscopic salpingectomy D) Oral contraceptives E) Emergency caesarean section Answer: B) Methotrexate injection Explanation: The diagnosis of an ectopic pregnancy with free fluid in the pelvis can be managed initially with a methotrexate injection (Choice B) to terminate the ectopic pregnancy. Surgical options like laparoscopic salpingectomy (Choice C) may be necessary in certain cases, but methotrexate is often attempted first. Choices A, D, and E are not the primary treatments for ectopic pregnancy.
