Do you need to definitively diagnose the location of a pregnancy of unknown location The case for yes
A definitive diagnosis should be made for PUL. Misclassification carries significant potential consequences. For nonviable PUL, presumptive diagnosis of EP without uterine curettage may be inaccurate.
Lauren Rubal, M.D., Karine Chung, M.D., M.S.C.E.
Volume 98, Issue 5, Pages 1078-1084, November 2012
Pregnancy of unknown location (PUL) is a common diagnostic challenge. The primary diagnostic goal is to ensure that the PUL is non-viable prior to proceeding with any invasive procedures. In non-viable PUL, there are several diagnostic and treatment strategies, all of which are in general quite safe. However, the management option that provides the most definite diagnosis is uterine curettage. We advocate use of uterine curettage in all cases of non-viable PUL because it limits exposure to a chemotherapeutic agent to only those who need it and it allows for the most accurate information for counseling the patient on prognosis of future pregnancies.