TY - JOUR
T1 - Pregnancy of unknown location
T2 - A consensus statement of nomenclature, definitions, and outcome
AU - Barnhart, Kurt
AU - Van Mello, Norah M.
AU - Bourne, Tom
AU - Kirk, Emma
AU - Van Calster, Ben
AU - Bottomley, Cecilia
AU - Chung, Karine
AU - Condous, George
AU - Goldstein, Steven
AU - Hajenius, Petra J.
AU - Mol, Ben Willem
AU - Molinaro, Thomas
AU - O'Flynn O'Brien, Katherine L.
AU - Husicka, Richard
AU - Sammel, Mary
AU - Timmerman, Dirk
N1 - Copyright:
Copyright 2011 Elsevier B.V., All rights reserved.
PY - 2011/3/1
Y1 - 2011/3/1
N2 - 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.
AB - 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.
KW - Nomenclature
KW - ectopic pregnancy
KW - international consensus
KW - pregnancy of unknown location
UR - http://www.scopus.com/inward/record.url?scp=79951947073&partnerID=8YFLogxK
U2 - 10.1016/j.fertnstert.2010.09.006
DO - 10.1016/j.fertnstert.2010.09.006
M3 - Article
C2 - 20947073
AN - SCOPUS:79951947073
SN - 0015-0282
VL - 95
SP - 857
EP - 866
JO - Fertility and Sterility
JF - Fertility and Sterility
IS - 3
ER -