Interstitial Pregnancy: From Medical to Surgical Approach-Report of Three Cases.
Case Rep Obstet Gynecol 2018;
2018:2815871. [PMID:
30410806 PMCID:
PMC6205099 DOI:
10.1155/2018/2815871]
[Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 09/24/2018] [Indexed: 11/17/2022] Open
Abstract
Background
Interstitial pregnancy is a rare form of ectopic pregnancy that usually leads to uterine rupture resulting in sudden life-threatening haemorrhage, need for blood transfusion, and admission to intensive care unit. Mortality rate is 6–7 times higher than that in classical ectopic pregnancy. Uterine rupture has been typically reported to occur at more advanced gestational ages compared to tubal pregnancy although several recent reports have shown a high risk of rupture before 12 weeks of gestation.
Cases Presentation
We report three cases of women affected by interstitial pregnancy, with different clinical symptoms, and managed to be treated with surgery or medical therapy. An emergency laparotomy was performed in the first case by the general surgeon, while in the second case laparoscopy was made by a gynecologist; last case shows the success of systemic administration of methotrexate.
Conclusion
Interstitial pregnancy is still a challenging condition to diagnose and treat; early diagnosis may help to choose the proper management.
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