Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Fertil Steril. 2011 Mar 1;95(3):857-66. doi: 10.1016/j.fertnstert.2010.09.006. Epub 2010 Oct 14.
To improve the interpretation of future studies in women who are initially diagnosed with a pregnancy of unknown location (PUL), we propose a consensus statement with definitions of population, target disease, and final outcome.
A review of literature and a series of collaborative international meetings were used to develop a consensus for definitions and final outcomes of women initially diagnosed with a PUL.
RESULT(S): Global differences were noted in populations studied and in the definitions of outcomes. We propose to define initial ultrasound classification of findings into five categories: definite ectopic pregnancy (EP), probable EP, PUL, probable intrauterine pregnancy (IUP), and definite IUP. Patients with a PUL should be followed and final outcomes should be categorized as visualized EP, visualized IUP, spontaneously resolved PUL, and persisting PUL. Those with the transient condition of a persisting PUL should ultimately be classified as nonvisualized EP, treated persistent PUL, resolved persistent PUL, or histologic IUP. These specific categories can be used to characterize the natural history or location (intrauterine vs. extrauterine) of any early gestation where the initial location is unknown.
CONCLUSION(S): Careful definition of populations and classification of outcomes should optimize objective interpretation of research, allow objective assessment of future reproductive prognosis, and hopefully lead to improved clinical care of women initially identified to have a PUL.
为了提高对最初诊断为不明部位妊娠（PUL）的女性的未来研究的解读，我们提出了一项共识声明，其中包含了人群、目标疾病和最终结局的定义。
通过文献回顾和一系列国际合作会议，制定了一个共识，用于定义最初诊断为 PUL 的女性的人群、目标疾病和最终结局。
研究人群和结局的定义存在全球性差异。我们建议将初始超声检查结果分为五类：明确的异位妊娠（EP）、可能的 EP、PUL、可能的宫内妊娠（IUP）和明确的 IUP。PUL 患者应进行随访，并将最终结局分类为可见的 EP、可见的 IUP、自然消退的 PUL 和持续的 PUL。那些持续 PUL 的短暂情况最终应归类为不可见的 EP、治疗性持续 PUL、消退性持续 PUL 或组织学 IUP。这些特定类别可用于描述任何早期妊娠的自然史或位置（宫内与宫外），初始位置未知。
仔细定义人群和分类结局应能优化对研究的客观解读，有助于客观评估未来的生殖预后，并有望改善最初诊断为 PUL 的女性的临床护理。
