Physical exam reveals the uterus to be about 6 wk size. Vaginal bleeding is scanty with no discernible tissue in the cervical os. There are no palpable adnexal masses. The uterus is mildly tender. Ultrasonographic exam does not reveal a gestational sac. Which of the following should be recommended?

• A. Dilatation & curettage.
• B. Culdocentesis.
• C. Observation followed by serial B-HCG determinations.
• D. Diagnostic laparoscopy.
• E. Laparotomy