A 29-year-old woman at 7 weeks 2 days gestation presents with right iliac fossa pain and minimal vaginal bleeding. She has a history of right salpingectomy for tubal ectopic pregnancy three years ago. Transvaginal ultrasound shows an empty central endometrial cavity and the structure marked **A** in the diagram—an eccentric gestational sac measuring 22 mm with a yolk sac and embryo with early cardiac activity located in the right cornual region. The myometrial mantle surrounding this sac is markedly thin (less than 4 mm). Free fluid with internal echoes is noted in the pouch of Douglas. Which of the following is the most appropriate immediate management for this patient?
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