Evaluation of PUL in a hemodynamically stable patient with an undesired pregnancy

PUL is a term used to describe the clinical scenario in which a patient with a positive pregnancy test has a TVUS that shows neither an IUP nor an ectopic pregnancy. PUL may be asymptomatic or present with vaginal bleeding and/or abdominal pain. This algorithm does not apply to hemodynamically unstable patients or those with uncommon or rare etiologies including, but not limited to, the following: malignancy (eg, invasive mole, choriocarcinoma), pituitary hCG production, heterophilic antibodies. These are described in related UpToDate content. Patients with PUL and a desired pregnancy are also managed differently.