Title: Clinical Profile and Outcome of Pregnancy of Unknown Location in A Tertiary Care Centre
Authors: Dr Jaya G, Dr Sathiamma PK
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.189
Abstract
Objectives: To study clinical profile and outcome of pregnancy of unknown location (PUL) in a tertiary care centre.
Methods: Study group comprised of 61 PUL cases in whom pregnancy test was positive but there was no ultrasound evidence of intrauterine (IUP) or extrauterine pregnancies (EP).Their clinical profile studied and outcome observed. Hemodynamically stable cases were followed up with serial blood human chorionic gonadotropin (betah CG) estimation and transvaginal ultrasound (TVS) until reaching the final outcome like EP, viable IUP, failed pregnancy or persistent PUL.
Results: Majority of patients presented with abdominal pain and vaginal bleeding. Maximum incidence was noted between 21-30 yrs of age. 57.4% of study subjects were nullipara, h/o infertility treatment was present in3.3% cases and 6.6% had previous history of EP. Out of the 61 women studied 36.1% ended up in EP, 32.8% in normal (IUP) and failing pregnancy around 31.1%. Majority required 2 values of hCG and 2TVS.
Conclusion: Most PULs are not aggressive but EP can be a life threatening outcome and its diagnosis is a biggest challenge. Prompt follow up with Ultrasound scanning (USS) and beta HCG is the mainstay in diagnosis and management of PUL. The help of an expert sinologist can reduce the incidence of PUL. Apelvic examination to assess the size of the uterus and delaying of USG till 7 weeks of gestation in asymptomatic women can to some extent reduce the incidence of PUL.
Keywords: Discriminatory zone. Gestational sac, HCG, Ectopic pregnancy.
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Dr Sathiamma PK
Anjanam, Valiyamaram Ward, Alappuzha, Kerala
Phone number 04772261989, 9847739527, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.