Surgically assisted medical management of interstitial ectopic pregnancy
Keywords:Fertility sparing, Conservative management, Interstitial ectopic pregnancy, SAM
An interesting case of interstitial ectopic pregnancy in a primigravida managed by surgically assisted medical management with intracardiac instillation of KCl and methotrexate. It was diagnosed based on transvaginal and transabdominal ultrasound and procedure was done as USG guided under local anaesthesia in OPD by transabdominal route and immediate disappearance of foetal cardiac activity was noted on Doppler. She was followed up with serial sβ-hCG and TVS. She had no post procedure complication and was discharged on day 2 of procedure.
Tinelli A, Malvasi A, Pellegrino M, Pontrelli G, Martulli B, Tsin DA. Laparoscopical management of cornual pregnancies: a report of three cases. Eur J Obstet Gynecol Reprod Biol. 2010;151(2):199-202.
Ross R, Lindheim SR, Olive DL, Pritts EA. Cornual gestation: a systematic literature review and two case reports of a novel treatment regimen. J Min Inv Gynecol. 2006;13:74-8.
Bouyer J, Coste J, Fernandez H, Pouly JL, Job-Spira N. Sites of ectopic pregnancy: a 10-year population-based study of 1800 cases. Hum Reprod. 2002;17: 3224-30.
Lau, S. and Tulandi, T.Conservative medical and surgical management of interstitial ectopic pregnancy. Fertil Steril 1999:72(2):207-15.
Yassin AS, Taha MS. Interstitial ectopic pregnancy, diagnosis and management: a case report and literature review. Ann Clin Case Rep. 2017;2:1352.
Cassik P et al .Factors influencing the success of conservative treatment of interstitial pregnancy. Ultrasound Obstet Gynecol. 2005:26(3):279-82.
Moawad NS. Current diagnosis and treatment of interstitial pregnancy. Am J Obstet Gynecol. 2010: 202(1):15-29.
Maymon R, Shulman A. Controversies and problems in the current management of tubal pregnancy. Hum Reprod Update.1996:541-51.
Poon LCY. How feasible is expectant management of interstitial ectopic pregnancy? Ultrasound Obstet Gynecol. 2014:43(3):317-21.
Tanaka T. Treatment of interstitial ectopic pregnancy with methotrexate: report of a successful case. Fertil Steril. 1982:37(6):851-2.
Stovall TG, Ling FW, Gray LA. Single-dose methotrexate for treatment of ectopic pregnancy. Obstet Gynecol. 1991:77(5):754-7.
Verma U, English D, Brookfield K. Conservative management of nontubal ectopic pregnancies. Fertil Steril. 2011:96(6):205-9.
Weissman A, Fishman A. Uterine rupture following conservative surgery for interstitial pregnancy. Eur J Obstet Gynecol Reprod Biol. 1992:44(3):237-9.
Cucinella G. Interstitial pregnancy: a ‘road map’ of surgical treatment based on a systematic review of the literature. Gynecol Obstet Investig. 2014:78:141-9.
Liao CY. Cornual wedge resection for interstitial pregnancy and postoperative outcome. Aust N Z J Obstet Gynaecol. 2017:57(3):342-5.