Assigned when neither an intrauterine pregnancy (IUP) or an ectopic pregnancy is identified on transvaginal ultrasound in the context of a positive pregnancy test

Aetiology

• Most likely underlying diagnosis is non-viable intrauterine pregnancy

Clinical features

• Amenorrhoea
• Abdominal pain
• Clinically well

Investigations

• TVUS: no evidence of pregnancy in uterus, fallopian tube, cervix, C-section scar or abdominal cavity on
• Bloods: HCG (static), progesterone
• PUL is not a clinical diagnosis unless fulfils criteria over subsequent assessments

Management

• For the hemodynamically stable patient, a short interval repeat ultrasound examination and quantitative beta-hCG are generally appropriate