{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:58:08Z","timestamp":1786978688099,"version":"build-2736575974"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2009,5,14]],"date-time":"2009-05-14T00:00:00Z","timestamp":1242259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2009,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the efficacy of a progesterone\u2010based algorithm for the management of women with pregnancies of unknown location (PULs) and explore the feasibility of developing a single\u2010visit strategy in those with a low risk of requiring medical intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All clinically stable women in whom pregnancy could not be identified on ultrasound scan were managed by a pre\u2010defined protocol based on measurement of serum progesterone and \u03b2\u2010human chorionic gonadotropin (\u03b2\u2010hCG). Intervention in the form of surgery or medical treatment with methotrexate was offered to all women with persistent or worsening symptoms and non\u2010declining serum \u03b2\u2010hCG. Decision\u2010tree analysis was used to develop a protocol for the management of women with resolving pregnancies who are at low risk of requiring medical intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>1110 women were included in the data analysis: normal intrauterine pregnancy was diagnosed in 248 (22.3%; 95% CI, 19.9\u201324.8) women. 761 (68.6%; 95% CI, 65.8\u201371.3) abnormal pregnancies resolved spontaneously on expectant management, while the remaining 101 (9.1%; 95% CI, 7.4\u201310.8) women with abnormal pregnancies required some form of medical intervention. Intervention rates in patients presenting with initial serum progesterone levels of \u2264 20 nmol\/L and \u2264 10 nmol\/L, were 3.9% (95% CI, 2.4\u20135.4) and 2.1% (95% CI, 0.9\u20133.3), respectively. In women presenting with progesterone \u2264 10 nmol\/L and \u03b2\u2010hCG &lt; 450 IU\/L, the intervention rate was 1.3% (95% CI, 0.2\u20132.5).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Women with PULs with progesterone \u2264 10 nmol\/L at presentation are at low risk of requiring medical intervention and may not benefit from attending routine follow\u2010up visits. Copyright \u00a9 2009 ISUOG. Published by John Wiley &amp; Sons, Ltd.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.6380","type":"journal-article","created":{"date-parts":[[2009,5,14]],"date-time":"2009-05-14T06:30:44Z","timestamp":1242282644000},"page":"704-710","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Use of serum progesterone measurements to reduce need for follow\u2010up in women with pregnancies of unknown location"],"prefix":"10.1002","volume":"33","author":[{"given":"A.","family":"Day","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Sawyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Mavrelos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Tailor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Helmy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Jurkovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,5,14]]},"reference":[{"key":"e_1_2_5_2_2","first-page":"770","article-title":"Comparison of abdominal and vaginal sonography in suspected ectopic pregnancy","volume":"73","author":"Cacciatore B","year":"1989","journal-title":"Obstet Gynecol"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2005.12.023"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.humrep.a136123"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1999.14040231.x"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2001.00031.x"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1995.05050353.x"},{"key":"e_1_2_5_8_2","volume-title":"Classification and Regression Trees","author":"Breiman L","year":"1984"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2004.04.004"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dem073"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2006.12.015"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.2636"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2006.00924.x"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh746"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/del460"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1061"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.6380","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.6380","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T07:58:04Z","timestamp":1697529484000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.6380"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,5,14]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2009,6]]}},"alternative-id":["10.1002\/uog.6380"],"URL":"https:\/\/doi.org\/10.1002\/uog.6380","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,5,14]]},"assertion":[{"value":"2009-03-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2009-05-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}