Pregnancy of Unknown Location

Pregnancy of Unknown Location

Department of Gynaecology

You have been given a diagnosis of pregnancy of unknown location. This leaflet will
explain what this means and what are the possible outcomes following this diagnosis.
Please ask for clarification if you do not understand something in the leaflet. You
would also be provided with a contact number to get in touch if you experience any
problems during your treatment with our unit.

What is pregnancy of unknown location mean?

This term is used when you have a positive pregnancy test but no pregnancy can be
seen following a careful internal ultrasound scan.

What are the possible reasons for pregnancy of unknown location?

1. You may have a very early pregnancy and therefore it is not possible to see. It is
   normal not to be able to see pregnancy of less than 6 weeks. This is also likely
   to happen when you are un-sure of your dates or have irregular cycles.
2. You may be undergoing a miscarriage. This usually presents with symptoms of
   pain or bleeding. You would still have a positive pregnancy test as the pregnancy
   hormone (BHCG) takes 3-4 weeks to clear out from your body.
3. You may have an ectopic pregnancy which is pregnancy located outside the
   lining of the womb.

What is ectopic pregnancy?

Pregnancy growing outside the lining of the womb is called ectopic pregnancy.
Majority of ectopic pregnancy grow in the fallopian tube. It can also implant on the
ovary and neck of the womb or rare occasions. Sadly it is not possible for ectopic
pregnancy to survive. It is important to identify and treat ectopic pregnancies due to
risk of rupture and bleeding. If you are diagnosed with ectopic pregnancy all the
treatment options will be discussed with you by the doctors and nurses.

What happens after the diagnosis of pregnancy of unknown location?

We will take detail history from you to help us in explaining the possible reason.

We would need to do some blood test which may also aid in the diagnosis. Hormones
are checked 48 hours apart. You would be contacted by the team to explain the results
and may require further scans before diagnosis can be made.

Outcomes after hormone test

As a general rule if you hormone levels go up significantly it is likely that you have a
normally located pregnancy in your womb and another scan will be arranged based on
your hormone levels. We still have to be cautious as some patients may still have an
ectopic pregnancy.

• If there is a sudden drop in your hormone levels especially if you also have
  history of pain and bleeding likely diagnosis of miscarriage is made and we
  advise you to do a home pregnancy test is 3-4 weeks.
• If the hormone levels do not fall or rise significantly a possibility of ectopic
  pregnancy is made and you would be seen by the medical team.
• Sometimes you may need more than 2 blood tests and repeat ultrasound scans
  before a diagnosis is made.
• We would advise you to monitor your symptoms and get in touch if you notice
  significant pain in your lower abdomen, feeling light headed, tummy upset,
  shoulder tip pain or experience heavy vaginal bleeding. Please contact these
  numbers.

EPAU and GAU Worcester Acute Hospitals NHS Trust: 01905 761489

If you feel very unwell or the symptoms are severe call an ambulance and present in
the nearest A & E department.

Helpful websites and associations where further information can be found

Ectopic pregnancy Trust Miscarriage Association
020 77332653 01924 200799
www.ectopicpregnancy.org.uk www.miscarriageassociation.org

If your symptoms or condition worsens, or if you are concerned about anything,
please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you
and your loved ones. If you have any questions or concerns, please do speak with a
member of staff on the ward or in the relevant department who will do their best to
answer your questions and reassure you.

Feedback
Feedback is really important and useful to us – it can tell us where we are working well
and where improvements can be made. There are lots of ways you can share your
experience with us including completing our Friends and Family Test – cards are
available and can be posted on all wards, departments and clinics at our hospitals. We
value your comments and feedback and thank you for taking the time to share this with
us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the
nurse in charge or the department manager in the first instance as they are best
placed to answer any questions or resolve concerns quickly. If the relevant member of
staff is unable to help resolve your concern, you can contact the PALS Team. We offer
informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf,
if you feel unable to do so, to resolve your problems and where appropriate refer to
outside help.

If you are still unhappy you can contact the Complaints Department, who can
investigate your concerns. You can make a complaint orally, electronically or in writing
and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Thursday from 8.30am to 4.30pm and
Friday: 8.30am to 4.00pm. Please be aware that a voicemail service is in use at busy
times, but messages will be returned as quickly as possible.

If you are unable to understand this leaflet, please communicate with a member of
staff.

Version 4.7