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A 27-year-old woman has 6 weeks of amenorrhea and mild right lower quadrant pain. Ultrasound shows a 2.8 cm unruptured right adnexal mass with no fetal cardiac activity. Serum hCG is 1,800 mIU/mL. She is hemodynamically stable and wants to preserve fertility. What is the most appropriate first-line management?

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Q. First line management of an unruptured ectopic in a stable patient?

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You picked surgery. The answer was methotrexate, first line when hCG is low and criteria are met.

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Q. First line management of an unruptured ectopic in a stable patient? Back, three days later.

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