Pregnancy of unknown location: a consensus statement of nomenclature, definitions, and outcome: a consensus statement of nomenclature, definitions, and outcome

Kurt Barnhart, Norah M. van Mello, Tom Bourne, Emma Kirk, Ben van Calster, Cecilia Bottomley, Karine Chung, George Condous, Steven Goldstein, Petra J. Hajenius, Ben Willem Mol, Thomas Molinaro, Katherine L. O'Flynn O'Brien, Richard Husicka, Mary Sammel, Dirk Timmerman

Research output: Contribution to journalArticleAcademicpeer-review

219 Citations (Scopus)

Abstract

Objective: To improve the interpretation of future studies in women who are initially diagnosed with a pregnancy of unknown location (PUL), we propose a consensus statement with definitions of population, target disease, and final outcome. Design: A review of literature and a series of collaborative international meetings were used to develop a consensus for definitions and final outcomes of women initially diagnosed with a PUL. Result(s): Global differences were noted in populations studied and in the definitions of outcomes. We propose to define initial ultrasound classification of findings into five categories: definite ectopic pregnancy (EP), probable EP, PUL, probable intrauterine pregnancy (IUP), and definite IUP. Patients with a PUL should be followed and final outcomes should be categorized as visualized EP, visualized IUP, spontaneously resolved PUL, and persisting PUL. Those with the transient condition of a persisting PUL should ultimately be classified as nonvisualized EP, treated persistent PUL, resolved persistent PUL, or histologic IUP. These specific categories can be used to characterize the natural history or location (intrauterine vs. extrauterine) of any early gestation where the initial location is unknown. Conclusion(s): Careful definition of populations and classification of outcomes should optimize objective interpretation of research, allow objective assessment of future reproductive prognosis, and hopefully lead to improved clinical care of women initially identified to have a PUL. (Fertil Steril (R) 2011; 95: 857-66. (C) 2011 by American Society for Reproductive Medicine.)
Original languageEnglish
Pages (from-to)857-866
Number of pages10
JournalFertility and Sterility
Volume95
Issue number3
DOIs
Publication statusPublished - 1 Mar 2011

Keywords

  • Consensus
  • Female
  • Global Health
  • Humans
  • Pregnancy
  • Pregnancy, Ectopic/diagnostic imaging
  • Risk Factors
  • Terminology as Topic
  • Ultrasonography, Prenatal/standards

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