Hysteroscopy as an Alternative to Curettage in Persistent Pregnancy of Unknown Location

This study evaluates the effectiveness of hysteroscopy in managing persistent pregnancy of unknown location (PUL) as an alternative to traditional curettage. Six patients diagnosed with PUL underwent hysteroscopy, four of them by the vaginoscopic approach and without anesthesia, and two under general anesthesia. The objective of the procedure was to locate the pregnancy, treat it, or take a tissue sample in cases of PUL where imaging studies were nonconclusive. Results showed that in five patients, hysteroscopy successfully identified and removed a gestational mass, leading to complete resolution of beta-human chorionic gonadotropin (ß-hCG) levels within 24 days. One patient was diagnosed with extrauterine pregnancy due to the absence of intrauterine gestational mass in hysteroscopy and a plateauing level of ß-hCG a day after the procedure. The findings indicate that hysteroscopy may offer a safe and more precise alternative to traditional blind curettage.