C is the correct answer

Salpingostomy is a procedure that involves incising the fallopian tube at the location of the ectopic pregnancy and subsequent removal of the ectopic pregnancy. While salpingectomy, or complete removal of the tube, has been the traditional option, salpingostomy is a conservative surgical approach that allows the patient to keep the affected fallopian tube. This is especially important to maintain fertility in a patient who has already had a unilateral salpingectomy. After a salpingostomy is performed, it is important to follow beta-human chorionic gonadotropin (hCG) levels until undetectable due to the possibility of retained trophoblastic tissue. If beta-hCG levels plateau, treatment with methotrexate may be necessary for the complete resolution of the ectopic pregnancy.

Methotrexate (A) is commonly used during outpatient management of an ectopic pregnancy. However, detecting fetal cardiac activity and a beta-hCG > 5,000 mIU/mL are both relative contraindications for outpatient management. A salpingectomy (B) should be performed when tubal rupture is noted. It should be avoided, if possible, to preserve fertility in someone with an absent or abnormal contralateral tube. Surveillance (D) is not appropriate in this scenario since there is a documented ectopic pregnancy.