Which of the following indicates a diagnosis of ectopic pregnancy?

The diagnosis of ectopic pregnancy is most accurately indicated by the presence of an extrauterine echogenic mass with fluid as observed on transvaginal ultrasound. Ectopic pregnancies occur when a fertilized egg implants outside the uterine cavity, most commonly in a fallopian tube. The ultrasound findings reveal the mass, which represents the ectopic tissue, and any associated fluid may indicate a hemorrhage, which is a common complication of ectopic pregnancies.

In contrast, a beta hCG rise of greater than 53% in 48 hours does not specifically indicate ectopic pregnancy; in normal early pregnancies, we would expect to see a more significant increase in hCG levels. The absence of pelvic pain also does not rule out ectopic pregnancy, as some patients may remain asymptomatic while having an ectopic. Lastly, the presence of an intrauterine pregnancy on ultrasound would actually suggest a viable intrauterine pregnancy rather than an ectopic one. Hence, the presence of an extrauterine echogenic mass with fluid is a critical finding that supports the diagnosis of an ectopic pregnancy.