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Trends in the Management of Nonviable Pregnancies of Unknown Location in the United States.
- Source :
-
Gynecologic & Obstetric Investigation . Nov2018, Vol. 83 Issue 6, p552-557. 6p. 4 Charts. - Publication Year :
- 2018
-
Abstract
- <bold>Background: </bold>When managing a nonviable pregnancy of unknown location (PUL), a debate has emerged in the literature whether to perform uterine curettage for definitive diagnosis of pregnancy location or administer methotrexate for a presumed ectopic pregnancy. The purpose of this study is to describe the treatment patterns when managing a PUL.<bold>Methods: </bold>A prospective, anonymous Internet based-electronic survey of PUL case scenarios was administered to a random sample of physicians across the United States.<bold>Results: </bold>A total of 214 physicians responded. When presented with a PUL by ultrasound and a βhCG measurement of 3,270 mIU/mL, which is above the discriminatory level, 88.3% (188) would choose an additional βhCG measurement before recommending any intervention. When presented with a PUL by ultrasound and serial βhCG measurements demonstrating an inappropriate trend for a viable gestation, 36.5% would offer uterine curettage and 31.3% would offer methotrexate. Resident and private clinicians had a fourfold lower adjusted odds of choosing uterine curettage compared to academic physicians.<bold>Conclusions: </bold>Based on our findings, there does not appear to be a consensus regarding the management of a PUL. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 03787346
- Volume :
- 83
- Issue :
- 6
- Database :
- Academic Search Index
- Journal :
- Gynecologic & Obstetric Investigation
- Publication Type :
- Academic Journal
- Accession number :
- 132894788
- Full Text :
- https://doi.org/10.1159/000488760