Pregnancy of Unknown Location

A pregnancy of unknown location is when you have a positive or detectable pregnancy test (preferably by a blood test beta-hCG), but the pregnancy is not visualized on the ultrasound. 

Pregnancy of unknown location describes a temporary state until a final diagnosis of developing intrauterine pregnancy, ectopic pregnancy, or pregnancy loss can be made. Most pregnancies of unknown location are intrauterine pregnancies, not ectopic. But until a location is confirmed, a pregnancy of unknown location should be considered as potentially ectopic. 

There are several possibilities regarding if you have a pregnancy of unknown location, and one of the most important aspects of your care is timely follow-up with your family physician, obstetrical care provider, or an early pregnancy clinic. If none of these options are available  to you, return to the Emergency Department to ensure serum beta-hCG blood work follow-up is completed.

Recommended management consists of two serial measurements of serum beta-hCG taken 48 hours apart. Whether beta-hCG is rising, falling, or has plateaued determines the next steps in care and the potential need for further ultrasounds or beta-hCG measurements.

Based on this follow-up blood work and/or ultrasound, If no intrauterine or ectopic pregnancy is diagnosed, people should be followed up until the beta-hCG level returns to zero.