**Question:** Treatment for choice for tubal pregnancy with no evidence of bleeding or rupture: September 2005

**Core Concept:** Tubal pregnancy is an ectopic pregnancy, where the fertilized egg implants outside the uterine cavity, typically in the fallopian tube. The treatment options depend on the patient's condition and the stage of the pregnancy.

**Why the Correct Answer is Right:**

The correct answer is D: **Observation and Oral Antiprogestin**.

In cases of tubal pregnancy with no evidence of bleeding or rupture, the treatment of choice is typically observation and oral antiprogestin administration. Antiprogestins are drugs that block progesterone action, leading to the regression of the fetus and the termination of the pregnancy. Observation is essential to monitor the patient's condition and ensure that the pregnancy remains stable without complications like hemorrhage or rupture.

**Why Each Wrong Option is Incorrect:**

A) **Surgery (salpingectomy)**: This option is incorrect because it involves surgical intervention, which is not necessary when the pregnancy is stable and there are no signs of bleeding or rupture.

B) **Surgery (salpingostomy)**: This option is also incorrect as it involves a surgical procedure, which is not required when the pregnancy is stable without complications.

C) **Observation without antiprogestin**: This option is not suitable because antiprogestin administration is crucial to ensure the regression of the fetus and avoid the progression of the pregnancy into a potentially life-threatening condition.

**Clinical Pearl:** In cases of tubal pregnancy, regardless of treatment choice, close monitoring is essential to ensure the condition does not deteriorate into a more severe situation.

**Correct Answer:** D) **Observation and Oral Antiprogestin**.