For a 25-year-old patient with pelvic pain and a Beta-HCG increase, what is the next best test for evaluation?

In the scenario presented, a 25-year-old patient with pelvic pain accompanied by an increase in Beta-HCG levels suggests the possibility of a pregnancy-related complication, such as an ectopic pregnancy or miscarriage. The most appropriate next step in evaluation is a transvaginal ultrasound.

Transvaginal ultrasound is particularly valuable in this context because it provides detailed imaging of the pelvic organs, including the uterus and ovaries. It can help confirm the location of a pregnancy (intrauterine or ectopic), assess for pelvic masses, or identify signs of complications such as free fluid indicating hemorrhage. Additionally, this imaging technique is non-invasive and can be performed quickly, which is critical in managing potentially acute situations like an ectopic pregnancy.

While other tests, such as laparoscopy, culdocentesis, or dilation and curettage, may be warranted in certain scenarios, they are generally not the first line of evaluation. Laparoscopy is a surgical procedure that is typically used for direct visualization and intervention when other less invasive diagnostics have failed or are not appropriate. Culdocentesis involves aspirating fluid from the cul-de-sac and is less commonly performed in contemporary practice; it is more useful for confirming the presence of free fluid but