Pregnancy of unknown location

All women with a positive pregnancy test who do not have a pregnancy visualised on transvaginal ultrasound, whether it is an intra-uterine pregnancy or an ectopic pregnancy, should be classified as having a ‘pregnancy of unknown location’ (PUL). Expectant management of haemodynamically stable asymptomatic women with a PUL has been shown to be safe. Serum human chorionic gonadotrophin levels, serum progesterone levels and mathematical models all have a role in the prediction of PUL outcome, which includes: a failing PUL, an intra-uterine pregnancy and an ectopic pregnancy. Surgical intervention in the form of diagnostic laparoscopy or uterine curettage does not have a role in the routine management of women with a PUL. This review article discusses the various aspects of management of women with a PUL.