Pregnancy of Unknown Location Must be Treated in Time, a Study Suggests

A new study by NIH suggests that preventive treatment of nonviable pregnancy is a preferable option, especially when the location of the fetus is uncertain. 

Experts suggest that the unknown location symptoms worsen with time, making it more complicated to treat. Therefore, on-time treatment becomes even more critical.

Although both treatments have been found effective, they come with their own set of complications, such as the risk of vaginal bleeding or complications in uterine tubes or fallopian tubes, etc. 

In a recent publication on the National Institutes of Health website, there are some interesting findings of unknown pregnancy treatments in women. 

Nonviable Pregnancy

Nonviable pregnancy is practically equivalent to no pregnancy at all. There are no chances of survival for a fetus or baby. Generally, it occurs due to Ectopic pregnancy.

A woman that is pregnant.

In an ectopic pregnancy, the eggs are implanted outside the uterus. Therefore, the baby doesn’t get a hospitable environment to grow. As a result, there is no chance of being born alive.

Detection for Pregnancy of Unknown Location

Although an unknown location pregnancy is a serious threat to the baby’s chances of survival, there are a few signs that can predict it. Here is a quick summary:

  • The progression of pregnancy is slower than expected
  • When the location of the fetus cannot be detected with ultrasound and other examination methods
  • Constantly low level of HCG (Human Chorionic Gonadotropin) hormone that is hidden by the cells. These cells later turn into the placenta, the essential organ for pregnancy.

Since the consistently lower HCG level determines the progression of slow pregnancy, a patient needs treatment to prevent any adverse reactions.

Consequences of Delay in Treatment

A nonviable pregnancy demands immediate treatment because the consequences can be unbearable. These consequences may include:

  • Severe Vaginal bleeding
  • Damage and scarring of uterine tubes
  • Mother’s death

Even if it doesn’t lead to death, the outcomes can induce complications in future pregnancies.

Research Resources

The M.D. of the University of Pennsylvania, Kurt T. Barnhart, and his colleagues conducted a study on nonviable pregnancy, which was later published in the journal of the American Medical Association. 

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) funded the study, and it was authored by Dr. Esther Eisenberg, the M.D. M.P.H. of the fertility and infertility branch at NICHD.

According to Dr. Esther, the doctors treat the patients of unknown pregnancies according to their will. Generally, the treatment methodologies depend upon the severity of the condition.

Most patients included in the study groups suggested they were pretty satisfied with the treatment methods.

Traditional Methods of Treatment

The traditional methods used to treat pregnancy for unknown locations include:

Drug Methotrexate

Doctors use Methotrexate, a kind of drug that lowers the immune function of a human body in a certain condition. Over the years, these drugs have been deemed acceptable to treat pregnancy for an unknown location. 


Evacuation is the process of cleaning the uterine lining. In this process, the doctor removes pregnancy tissue surgically from the uterus. The process approximately takes 3 three hours.

Expectant Management

In this process, the doctor keenly observes a patient’s condition without treating it. The doctors treat the problem when the symptoms begin to increase or the test results change.

Current Study

The experts involved approximately 250 participants for the present study. The patients who received methotrexate either with uterine evacuation or without it had reported a higher recovery rate. Interestingly, they didn’t receive any additional treatment.

On the other hand, those who received expectant management had different results.

Five out of all patients underwent surgery for ectopic pregnancy. Two of those belonged to the expectant management group, while one of them received methotrexate. The remaining two had gone through uterine evacuation.

All the patients received methotrexate treatment, either with evacuation or expectant management. On the other hand, some of them only received methotrexate.

The experts randomly chose participants in different categories for the current study. These participants were free to leave their group and decide to be a part of another treatment group.

More than 25% left the expectant management group, nearly 50% declined to the evacuation group, and roughly 40% left the two-dose methotrexate group.

Findings from the Research

Interestingly, the patients who were picked for evacuation and methotrexate groups achieved better results concerning their pregnancy issues. Besides, they were less likely to require additional treatments to resolve their problems.

Comparatively, the participants from the expectant group were not as satisfied as the rest of the participants were.

Overwhelmingly, the patients from the two-doses group were the most satisfied ones. They hardly needed additional treatments. 

Those who underwent uterine evacuation were slightly more likely to receive additional treatment. 

The most common contrary reaction in all three treatment methods was severe vaginal bleeding. Almost 45% to 55% of patients reported this adverse effect of treatment.

An Interesting Development During the Research

A patient from the expectant group later reported a progressing fetus in her uterus. It’s a rare phenomenon as lower HCG levels do not present viable growth conditions for the fetus. On top of that, the doctors observed that the patient’s HCG level began to rise in a week.

Woman that is pregnant with a baby.

Even though the woman conceived the baby through infertility treatment, she went on to complete her pregnancy period and delivered her baby without any complications. 

The author emphasized that such an experience highlights the need for proper examination before giving any treatment. It also confirms that pregnancy of an unknown location isn’t necessarily nonviable.

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Pregnancy in unknown locations is one of the major threats to women’s health all around the world. Such a type of pregnancy needs proper diagnosis and treatment on time. Otherwise, it can cause a lot of damage to a woman’s health. Besides, it can be harmful to future pregnancies.

Medical experts use traditional ways to treat such kinds of pregnancies. So, if the mother stays in touch with her gynecologist and follows the guidelines, it can help avoid severe complications during the pregnancy period and at the time of delivery.

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