Summary:
The term ‘pregnancy of unknown location (PUL) is used whenever there is no sign
of either intra- or extrauterine pregnancy or retained products of conception
on transvaginal ultrasound, despite a positive pregnancy test. A pregnancy site
will not be visualised in 8–31% of early pregnancy scans, although a lower
incidence (8–10%) has been observed in specialised scanning units. The
sonographer’s experience influences the prevalence of PUL. Whether the
pregnancy is intrauterine or ectopic and the precise extrauterine location
guides the remainder of the evaluation and management. Early diagnosis of
ectopic pregnancy is important to avoid adverse sequelae of this potentially
life-threatening condition. The management of PUL seems to be highly crucial in
obstetrics clinics.
Therefore, in the current study, issues identified from the literature related
to pregnancy of unknown location, potential tools for prediction and algorithms
are being discussed. This study also addresses in detail the diagnostic
approach and monitoring of pregnancy of unknown location, and the treatment
options.
Keywords:
Pregnancy of unknown location, β-hCG, Ectopic pregnancy, Miscarriage, Methotrexate
