Pregnancy of unknown location

- Serum HCG levels are below the discriminatory zone 

(level at which it is assumed that a viable intra-uterine pregnancy would be visualised on trans-vaginal scan: 1000 - 2000 iu/l)

 - If no pregnancy is detectable on scan, the pregnancy is of unknown location

 -Women with minimal / no symptoms can be managed expectantly with 48-72h follow-up 

 - Intervention may be required in 23-29% of cases

 - Serum HCG should be monitored until below 20iu/l

- Indications for active management -
 1. patient becomes symptomatic, 
 2. HCG levels rise above discriminatory zone or levels plateau