Management of pregnancy of unknown location

Pregnancy of unknown location (PUL) refers to a condition in which a woman has a positive pregnancy test without definite sign of pregnancy on transvaginal ultrasound. The main concern about PUL could be lethal if a patient isn't diagnosed with ectopic pregnancy timely. Therefore, triaging women with high risk is a primary goal in the management of women with PUL. On the premise of ensuring safety, many efforts have been made to offer both efficient and satisfactory treatment for women with PUL in recent years. This review provides an overview of factors that should be considered during the diagnosis and treatment progress of PULs. Mathematical prediction models, incorporating more than serum human chorionic gonadotropin and progesterone levels, exhibit satisfying performance in triaging women with PUL. As assisted reproductive technologies advance by leaps and bounds, a new indicative of estimating the intervention risk occurs in the management of PULs following assisted reproductive technologies. In the meanwhile, patient-centered care, an important principle in clinical practice, and other potential biomarkers deserve our attention. Hopefully, this review could offer some potential research avenues and trigger future advancements in the management of PUL.