A 28-year-old woman (G2P1) with a history of pelvic inflammatory disease and copper IUD in situ presents with 7 weeks of amenorrhoea, sudden severe right pelvic pain, and syncope. She is haemodynamically unstable (HR 118, BP 88/54) with shoulder-tip pain and right iliac fossa rebound tenderness. Beta-HCG is 3,200 mIU/mL. Transvaginal ultrasound reveals the structure marked **A** (complex right adnexal mass) adjacent to an empty uterus with free fluid in the pouch of Douglas. What is the most appropriate immediate management?
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