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Pregnancy of unknown location: a diagnostic and management dilemma 

Pregnancy of unknown location: a diagnostic and management dilemma
Chapter:
Pregnancy of unknown location: a diagnostic and management dilemma
Author(s):

Sarah Merritt

DOI:
10.1093/med/9780199654994.003.0003
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date: 23 September 2019

Whilst abdominal pain in early pregnancy is a common symptom, ectopic pregnancy must be suspected in all women presenting with pain in early pregnancy, in the absence of confirmed ultrasound diagnosis of intra-uterine pregnancy. This case describes a case of persistent pregnancy of unknown location (PUL), and highlights the role of serum markers such as BHCG and progesterone to aid diagnosis and management, as well as the importance of managing cases such as these in dedicated early pregnancy units. With a clinically healthy patient, a common error is inappropriately early follow-up, given that the majority of outcomes of PUL’s need time to manifest themselves, to avoid potentially unnecessary intervention. This case builds on recommendations provided by the National Institute of Clinical Excellence on how to manage inconclusive cases such as this one.

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