Predicting Outcomes in Pregnancies of Unknown Location

Emma Kirk; Tom Bourne


Women's Health. 2008;4(5):491-499. 

In This Article

Diagnostic Laparoscopy

The combination of a positive serum hCG above a discriminatory zone of 1000-2000IU/l and an empty uterus shown by TVS is an accepted indication for diagnostic laparoscopy in many units. However, as discussed previously, using a single value of serum hCG to predict PUL outcome is of limited value.[13] Many women with ectopic pregnancies have a low serum hCG, below that used in discriminatory zones and, therefore, would not undergo laparoscopy. By contrast, some failing PULs and early IUPs have high serum hCG levels and will undergo an unnecessary laparoscopy. Indications for diagnostic laparoscopy should be dependent upon the quality of the ultrasound equipment, the experience of the sonographer, prior knowledge of the woman's risks and symptoms and the presence of physical factors, such as uterine fibroids.[13]


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