Ectopic pregnancy ( NICE )

1. A 24-year-old nulliparous woman undergoes surgical management of a tubal ectopic pregnancy. At laparoscopy, the contralateral tube is examined and noted to be damaged. The woman has strongly expressed her concern about future fertility.
Which is the single best management option?

2. 22year old women presented with 6 weeks gestation, complains of mild pain abdomen with moderate vaginal bleeding .
Hemodynamically stable ,
Abdomen and vagina examination is insignificant
Urine pregnancy test positive .
TVs scan- no intrauterine sac , both tubes &ovaries -Normal
No free fluid

What’s appropriate management plan?

3. 32-year-old primiparous woman presents to the emergency department with sudden onset of lower abdominal pain, mainly localised in the left iliac fossa. The pain is sharp in nature and is radiating to the left flank.
Her last menstrual period was 7 weeks ago.
History of recurrent PID noted.
Vital signs on arrival are:
blood pressure = 90/60 mmHg & pulse = 100 beats/min, temperature = 36.5°C, respiratory rate = 16/min
Vaginal examination is positive for cervical excitation.
Investigations : A urine pregnancy test is positive. , hCG level = 5000 iu/l.
On transvaginal scan – left adnexa was seen to contain an ectopic pregnancy measuring 22 mm x 18 mm x 15 mm with noted cardiac activity and presence of haemoperitoneum noted.

What is the treatment of choice for this woman?