THE DETERMINATION OF VARIOUS OUTCOMES OF THE PREGNANCY OF UNKNOWN LOCATION AND ITS CHOICE OF MANAGEMENT

Objective: The research objective is to determine the outcome of pregnancy of unknown location of cohort women treated in a tertiary-care hospital. Methods: We conducted this prospective study at Services Hospital, Lahore (January 2017 to February 2018). We collected data for women with a history of bleeding/pain, amenorrhoea, and early pregnancy. The selected women underwent trans-vaginal ultrasonography once every week and beta-human chorionic gonadotropin levels two times every week. We did expectant management (EM) for failing PoUL and medical/surgical management for ectopic pregnancy and persistent PoUL. Results: Out of 7215 patients, we found 30.60% (2212) with early pregnancy. The sample size was 2.53% (183) as these patients fulfilled inclusion criteria. The number of patients presented with amenorrhoea, bleeding, and the pain was 71.6% (131), 49.2% (90), and 50.8% (93) respectively. At the outcome, the number of failing PoUL, intrauterine pregnancy, ectopic pregnancy, and persistent PoUL was 54.6% (100), 31.7% (58), 7.7% (14), and 6% (11) respectively. We treated patients of persistent PoUL (All) and EP (05 or 36%) immediately. We managed the EP patients (05) surgically. Conclusions: The choice of management for asymptomatic patients with PoUL is EM. The suspicion rate of persistent PoUL and EP was higher among patients for which, medical management is a better choice. Keywords: Pregnancy of Unknown Location (PoUL), Ectopic Pregnancy (EP), Expectant Management (EM), Ectopic Pregnancy (EP), Discriminatory Zone (DZ), Surgical Management (SM), and Medical Management (MM)