23 year old Female presents with 42 days of amenorrhea and vaginal spotting. Which of the following is the most useful diagnostic test?

In this case, firstly we will do TVS to look for G-sac and cardiac activity to rule in or rule out Pregnancy. A TVS would also confirm bility, since the patient has presented with bleeding pv which could be a sign of an aboion. Method Gestational Sac Cardiac activity TVS 4+ weeks 5+ weeks TAS 5+ weeks 6+weeks