The Obstetrician & Gynaecologist 2008;10:4:224-230
doi: 10.1576/toag.10.4.224.27438
Copyright © 2008 by the Royal College of Obstetricians and Gynaecologists.
Pregnancy of unknown location: an evidence-based approach to management
Haritha Sagili, MD MRCOG DFSRH MFSRH, Senior House Officer1 and
Kamel Mohamed, MSc MRCOG DFFP MD, Consultant Obstetrician and Gynaecologist2
1. Department of Obstetrics and Gynaecology, Nobles Hospital, The Strang, Braddan, Isle of Man IM4 4RJ, UK Email: harithas{at}hotmail.com (corresponding author)
2. Nobles Hospital, Isle of Man, UK
Key content:
- As women are presenting to early pregnancy assessment units at increasingly earlier gestations and are having earlier scans, the incidence of pregnancy of unknown location (PUL) is increasing.
- Although the vast majority will be failing PULs or intrauterine pregnancies, a small subset will be ectopic pregnancies; it is the detection of women in this group that poses the greatest challenge.
- Conservative management of PUL results in lower rates of unnecessary intervention, as the condition often resolves spontaneously; the difficulty is in determining which ones will not.
Learning objectives:
- To learn about the definition and clinical outcomes.
- To appreciate the role of biochemical tests and ultrasound in the assessment of women with PUL.
- To learn about conservative, medical and surgical management options.
Ethical issues:
- Is destroying a viable intrauterine pregnancy an acceptable cost for treating all ectopic pregnancies, given the limitations of diagnosis in PUL?
Please cite this article as: Sagili H, Mohamed K. Pregnancy of unknown location: an evidence-based approach to management. The Obstetrician & Gynaecologist 2008;10:224–230.
Keywords ectopic pregnancy / human chorionic gonadotrophin (hCG) / intrauterine pregnancy / progesterone
Copyright © 2008 by the Royal College of Obstetricians and Gynaecologists.
