This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: All India exam, Subject name: Gynaecology & Obstetrics
Management of tubal ectopic pregnancy of 2.5 x 3 cm is - 
Select and explain. 
A. Medical management, B. Salpingectomy, C. According to presence of fetal cardiac activity, D. Observation
C: According to presence of fetal cardiac activity
Answer: C: According to presence of fetal cardiac activity 
Explanation: According to presence of fetal cardiac activity Conservative management Medical management : Hemodynamically stable Serum hCG level < 3000IU/L Tubal diameter < 4 cm without any fetal cardiac activity No intraabdominal haemorrhage Surgical management : Hemodynamic instability Serum hCG level > 3000 IU/L Tubal diameter > 4 cm Presence of fetal cardiac activity Ref : Dutta book of obstetrics 8th Ed