Optimal Treatment for Women With a Persisting Pregnancy of Unknown Location

This was a randomized controlled trial to compare three currently available management strategies for women with a persisting pregnancy of unknown location (PPUL), which made them at-risk for ectopic pregnancy. The study recruited hemodynamically stable women with a confirmed PPUL to be randomized to one of three strategies: 1) Uterine evacuation followed by methotrexate (MTX) for some (those that had evidence of a non-visualized ectopic pregnancy), 2) Empiric treatment with MTX for all, or 3) Expectant management. Randomization was 1:1:1 into these three arms. After randomization, they were followed and treated clinically, as was indicated by the progression of their condition. Primary outcome measures were the uneventful decline of hCG to 5 IU/mL.